Kevin Andrew Brewer, D.D.S. MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DDS104871 Issued in CA

Practice address

7677 Center Ave Ste 409
Huntington Beach, CA 92647-3098

Phone

(714) 897-3543

Fax

(714) 897-0505

NPI assigned

May 29, 2008

Last updated

Nov 10, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 26, 2023 through Jan 26, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: kbrewer844192@direct.memorialcare.org

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1396903134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7677 CENTER AVE STE 409",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473098",
            "telephone_number": "714-897-3543",
            "fax_number": "714-897-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7677 CENTER AVE STE 409",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926473098",
            "telephone_number": "714-897-3543",
            "fax_number": "714-897-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "653 W 8th St",
            "address_2": "Faculty Clinic 3rd Floor",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322096511",
            "country_code": "US",
            "telephone_number": "904-244-3689",
            "fax_number": "904-244-3870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREWER",
        "first_name": "KEVIN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S. MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "DDS104871",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent O Nichols DDS Apc
• Brenwitz Inc. (The Workout Fitness Studio)
• Gracie Brestel
• Tiffany Leyla Brett
• Adrienne Brewer, MA, BCBA
• Brian Nguyen DMD, Inc
• Ashley Bribiescas
• Marcella Briceno, MFT LICENSED
• Crystal Leigh Brieden, P.A.
• Irene Briggs, LMFT

• Oral and Maxillofacial Surgery (Dentist) in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.