Andrea S. Braun, DDS
Individual provider Active NPI Dentist · Roseburg, OR
NPI 1386668044 · NPPES record last updated May 3, 2023
Key facts
- NPI
- 1386668044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 11607 (OR)
- Practice address
- 1729 W Harvard Ave Ste 1
Roseburg, OR 97471-2795 - Phone
- (541) 673-0131
- Fax
- (541) 673-0176
- NPI assigned
- Jul 27, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11607 | OR | MD | Dentist |
| 32907 | CA | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roseburg Family Dental Care | Current |
Accepting new patients |
Locations
1729 W Harvard Ave
Ste 1
Roseburg, OR 97471
Phone (541) 673-0131
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 32907 | CA | |
| Dentist | 122300000X | 11607 | OR | Yes |
Addresses
Primary practice location
1729 W Harvard Ave Ste 1
Roseburg, OR 97471-2795
Mailing address
1729 W Harvard Ave Ste 1
Roseburg, OR 97471-2795
Phone (416) 730-1315
Other providers in Roseburg, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.