Individual provider Active NPI

Brian C Warner, DMD

  • Endodontics
  • Boulder, CO
National Provider Identifier
1356577381
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DEN00203071 Issued in CO
Practice address
5400 Idylwild TR
Suite 101
Boulder, CO 80301
Phone
(720) 722-4111
NPI assigned
Jun 4, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DEN00203071 CO Primary

Addresses

Primary practice location

5400 Idylwild TR
Suite 101
Boulder, CO 80301

Mailing address

5400 Idylwild TR
Suite C
Boulder, CO 80301-3720
Phone (720) 722-4111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171013001312 CO Order and Referring Only - DentistPractitioner - Dentist 2062787294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DEN00203071COMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Warner Endodontics, PLLC Endodontics CurrentSince Nov 10, 2024 Accepting new patients

Locations

5400 Idylwild Trl
Unit C
Boulder, CO 80301
Phone (720) 722-4111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1244073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1356577381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 IDYLWILD TR",
            "address_2": "SUITE C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803013720",
            "telephone_number": "720-722-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 IDYLWILD TR",
            "address_2": "SUITE 101",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80301",
            "telephone_number": "720-722-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER",
        "first_name": "BRIAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-04",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "DEN00203071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.