Individual provider Active NPI

Brandy Nicole Behrens, DDS

  • Dentist
  • Rockville, MD
National Provider Identifier
1396184396
Registry record updated Jun 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15385 Issued in MD
Practice address
11404 Old Georgetown Rd
#204
Rockville, MD 20852-2865
Phone
(301) 770-1447
NPI assigned
Jun 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 15385 MD Primary

Addresses

Primary practice location

11404 Old Georgetown Rd
#204
Rockville, MD 20852-2865

Mailing address

13211 Meander Cove Dr
Germantown, MD 20874-3731
Phone (315) 250-2162

Other names 1

  • Brandy Nicole Page Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20150601001430 MD Order and Referring Only - DentistPractitioner - Dentist 5890016067

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
15385MDMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1372032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372032000000",
    "number": "1396184396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13211 MEANDER COVE DR",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208743731",
            "telephone_number": "315-250-2162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11404 OLD GEORGETOWN RD",
            "address_2": "#204",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208522865",
            "telephone_number": "301-770-1447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEHRENS",
        "first_name": "BRANDY",
        "middle_name": "NICOLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-24",
        "last_updated": "2013-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "15385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "PAGE",
            "middle_name": "NICOLE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.