Brian James Maduri, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901017417 Issued in MA

Practice address

101 20TH St N
Battle Creek, MI 49015-1701

Phone

(269) 963-1746

NPI assigned

Nov 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Kristen Gable, DMD PLC

  • General Practice Dentistry
  • Battle Creek, MI
  • NPI 1245840768
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376617399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 20TH ST N",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151701",
            "telephone_number": "269-963-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 20TH ST N",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490151701",
            "telephone_number": "269-963-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADURI",
        "first_name": "BRIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "2901017417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLU SHIELD",
            "identifier": "17417",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID, DELTA",
            "identifier": "383616883",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gracie Jo Macphee
• James Edwin Macvicar, M.D.
• Chandramouli Madala, MD
• Devan Madden
• Gabby Maddix
• Staci Marie Maguire, PA-C
• Thomas Maier, MD
• Lindsay Mailloux, PHARMD
• Bret Mains
• Ashley M Majdan, OTR/L

• General Practice Dentistry in Battle Creek, MI
• Providers in Battle Creek, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.