Individual provider Active NPI

Brianna Kosecki, DDS

  • Dentist
  • Bay City, MI
National Provider Identifier
1396433124
Registry record updated Oct 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901602013 Issued in MI
Practice address
800 S Euclid Ave Ste 4
Bay City, MI 48706-3355
Phone
(989) 686-1700
NPI assigned
Apr 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901602013 MI Primary

Addresses

Primary practice location

800 S Euclid Ave Ste 4
Bay City, MI 48706-3355

Mailing address

1407 Conrad Rd
Standish, MI 48658-9216
Phone (989) 324-9706

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
2901602013MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Dental CurrentSince Oct 13, 2024 Accepting new patients

Locations

800 S Euclid Ave
Ste 4
Bay City, MI 48706
Phone (989) 686-1700

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": "1682640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728604800000",
    "number": "1396433124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 CONRAD RD",
            "city": "STANDISH",
            "state": "MI",
            "postal_code": "486589216",
            "telephone_number": "989-324-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S EUCLID AVE STE 4",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487063355",
            "telephone_number": "989-686-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSECKI",
        "first_name": "BRIANNA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-28",
        "last_updated": "2024-10-11",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901602013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2024; 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.