Individual provider Active NPI

Brett Michael Germain, D.D.S.

  • General Practice Dentistry
  • Usaf Academy, CO
National Provider Identifier
1366758906
Registry record updated Aug 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12787 Issued in MN
Practice address
2355-B Faculty Dr.
Usaf Academy, CO 80840
Phone
(719) 333-5192
NPI assigned
Aug 20, 2010
Last updated
Aug 20, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2010

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 D12787 MN Primary

Addresses

Primary practice location

2355-B Faculty Dr.
Usaf Academy, CO 80840

Mailing address

2355-B Faculty Dr
10TH Dental Squadron/SGD
Usaf Academy, CO 80840
Phone (719) 333-5192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20160620001177 TN Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7517258742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12787MNMDGeneral Practice Dentistry
10021TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tullahoma Family Dentistry PLLC General Practice CurrentSince Mar 16, 2021 Accepting new patients

Locations

304 E Lincoln St
Tullahoma, TN 37388
Phone (931) 461-9030

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282262400000",
    "number": "1366758906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355-B FACULTY DR",
            "address_2": "10TH DENTAL SQUADRON/SGD",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "80840",
            "telephone_number": "719-333-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2355-B FACULTY DR.",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "80840",
            "telephone_number": "719-333-5192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERMAIN",
        "first_name": "BRETT",
        "middle_name": "MICHAEL",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-20",
        "last_updated": "2010-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Usaf Academy, CO

Sources for this page

Verify at the official NPI Registry.