Breacya Washington, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7009 Issued in KY

Practice address

3015 Wilson Ave
Louisville, KY 40211-1969

Phone

(502) 774-4401

Fax

(502) 774-4401

NPI assigned

Dec 6, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in KY

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

State licenses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385424000000",
    "number": "1386702603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3015 WILSON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111969",
            "telephone_number": "502-774-4401",
            "fax_number": "502-774-4401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3015 WILSON AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402111969",
            "telephone_number": "502-774-4401",
            "fax_number": "502-774-4401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASHINGTON",
        "first_name": "BREACYA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2013-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60070091",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hira Waseem
• Kelly M Washam, PT
• Bailey Washburn, PT, DPT
• Jennifer Nicole Washburn, NP
• Mitchell Lloyd Washburn, FNP
• Brittiney Washington
• Dion Washington Sr.
• Hillary Washington, PYSD, MA
• Jackey Rochele Washington, LPCC
• Joe Washington III

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2013; 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.