Individual provider Active NPI

Brennan Michael Mercola, DDS

  • General Practice Dentistry
  • Slidell, LA
National Provider Identifier
1386483907
Registry record updated Dec 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7536 Issued in LA
Practice address
170 Northshore Blvd Ste B
Slidell, LA 70460-6849
Phone
(985) 426-5726
NPI assigned
May 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2025

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 7536 LA Primary

Addresses

Primary practice location

170 Northshore Blvd Ste B
Slidell, LA 70460-6849

Mailing address

170 Northshore Blvd Ste B
Slidell, LA 70460-6849

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7536LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Dental Mobile LLC CurrentSince May 26, 2024 Accepting new patients

Locations

1700 6th Ave N
Bessemer, AL 35020
Phone (205) 423-2031

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": "1716336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765584000000",
    "number": "1386483907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 NORTHSHORE BLVD STE B",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704606849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 NORTHSHORE BLVD STE B",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704606849",
            "telephone_number": "985-426-5726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCOLA",
        "first_name": "BRENNAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-22",
        "last_updated": "2025-12-13",
        "certification_date": "2025-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2025; 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.