Individual provider Active NPI

Brian Timothy Seese, DMD

  • General Practice Dentistry
  • Davidson, NC
National Provider Identifier
1366579294
Registry record updated Sep 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7804 Issued in NC
Practice address
610 Jetton St Ste 250
Davidson, NC 28036-9323
Phone
(704) 895-5095
Fax
(704) 895-5097
NPI assigned
Feb 27, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7804 NC Primary

Addresses

Primary practice location

610 Jetton St Ste 250
Davidson, NC 28036-9323

Mailing address

610 Jetton St Ste 250
Davidson, NC 28036-9323
Phone (704) 895-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20160303002727 NC Order and Referring Only - DentistPractitioner - Dentist 4385940105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7804NCMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brian T. Seese, D.M.D., P.a. PastSince Oct 1, 2023 Accepting new patients

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695859200000",
    "number": "1366579294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 JETTON ST STE 250",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280369323",
            "telephone_number": "704-895-5095",
            "fax_number": "704-895-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 JETTON ST STE 250",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280369323",
            "telephone_number": "704-895-5095",
            "fax_number": "704-895-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEESE",
        "first_name": "BRIAN",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2023-09-28",
        "certification_date": "2023-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

Verify at the official NPI Registry.