Individual provider Active NPI

Bryan Noel Nokelby, D.D.S.

  • General Practice Dentistry
  • Napa, CA
National Provider Identifier
1417041880
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42941 Issued in CA
Practice address
2291 Soscol Ave
Napa, CA 94558-3620
Phone
(707) 226-2627
Fax
(707) 226-5730
NPI assigned
Oct 3, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 42941 CA Primary

Addresses

Primary practice location

2291 Soscol Ave
Napa, CA 94558-3620

Mailing address

2291 Soscol Ave
Napa, CA 94558-3620
Phone (707) 226-2627

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
42941CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417041880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 SOSCOL AVE",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583620",
            "telephone_number": "707-226-2627",
            "fax_number": "707-226-5730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2291 SOSCOL AVE",
            "city": "NAPA",
            "state": "CA",
            "postal_code": "945583620",
            "telephone_number": "707-226-2627",
            "fax_number": "707-226-5730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOKELBY",
        "first_name": "BRYAN",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Napa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.