Ivy Pauline Brisbin, DDS, MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10451 Issued in NC

Practice address

1107 S Fifth St Ste 100
Mebane, NC 27302-9596

Phone

(919) 568-0103

NPI assigned

May 10, 2016

Last updated

Aug 13, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Interoperability endpoints

• Direct secure messaging: ibrisbin193081@direct.unc.nchie.net

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

{
    "created_epoch": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1376999342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 MORGAN CREEK RD",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275174934",
            "telephone_number": "980-234-0374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S FIFTH ST STE 100",
            "city": "MEBANE",
            "state": "NC",
            "postal_code": "273029596",
            "telephone_number": "919-568-0103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Brauer Hl",
            "address_2": "Campus Box 7450",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275997450",
            "country_code": "US",
            "telephone_number": "919-537-3955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRISBIN",
        "first_name": "IVY",
        "middle_name": "PAULINE",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NC",
            "license": "10451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Maxwell Bohrer, CRNA
• Carmen Bork, LMFT
• William Harold Branham, D.M.D.
• Kwadwo Aniboe Brenya, DDS
• Brightside Care, PLLC
• Avery Brown
• Jill Ann Brown, DCN RDN LDN IFNCP
• Bruce D Browner, MD
• Garrett Adam Buchanan, DDS
• Kyle Patrick Burks, PHARM.D.

• Pediatric Dentistry in Mebane, NC
• Providers in Mebane, NC by specialty
• Pediatric Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.