Active NPI
Chadwick Brantley, D.M.D.
- Dentist
- Martinez, GA
National Provider Identifier
1396150256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN014788
- Practice address
- 495 Furys Ferry Rd
Martinez, GA 30907 - Phone
- (706) 863-7351
- NPI assigned
- Jun 29, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN014788 | GA | Primary |
Addresses
Primary practice location
495 Furys Ferry Rd
Martinez, GA 30907
Mailing address
14 Fallmouth Dr
North Augusta, SC 29841-3659
Phone (706) 825-6198
Other practice location 1
1234 Augusta West Pkwy
Augusta, GA 30909
Phone (706) 863-7351
Other practice location 2
127 Telfair St
Augusta, GA 30901-2590
Phone (706) 922-0600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160831001946 | GA | Practitioner - Dentist | 2365744216 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Dental Specialists, P.C. | Past | Accepting new patients |
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.
-
- Pediatric Dentistry
- Martinez, GA
- NPI 1598782310
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404000000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700524800000",
"number": "1396150256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 FALLMOUTH DR",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298413659",
"telephone_number": "706-825-6198"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "495 FURYS FERRY RD",
"city": "MARTINEZ",
"state": "GA",
"postal_code": "30907",
"telephone_number": "706-863-7351"
}
],
"practiceLocations": [
{
"address_1": "1234 Augusta West Pkwy",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "30909",
"country_code": "US",
"telephone_number": "706-863-7351",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "127 Telfair St",
"address_purpose": "LOCATION",
"city": "Augusta",
"state": "GA",
"postal_code": "309012590",
"country_code": "US",
"telephone_number": "706-922-0600",
"fax_number": "706-922-0603",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRANTLEY",
"first_name": "CHADWICK",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-29",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN014788",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Martinez, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.