Individual provider Active NPI

C Michael Brinker, DMD PSC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Florence, KY
National Provider Identifier
1427145366
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
4315 Issued in KY
Practice address
8172 Mall Road
Suite 214
Florence, KY 41042
Phone
(859) 525-2257
Fax
(859) 282-4372
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

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
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 4315 KY Primary

Addresses

Primary practice location

8172 Mall Road
Suite 214
Florence, KY 41042

Mailing address

8172 Mall Road
Suite 214
Florence, KY 41042
Phone (859) 525-2257

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
4315KYMDOral & Maxillofacial Surgery (D.M.D.)

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1427145366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8172 MALL ROAD",
            "address_2": "SUITE 214",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-525-2257",
            "fax_number": "859-282-4372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8172 MALL ROAD",
            "address_2": "SUITE 214",
            "city": "FLORENCE",
            "state": "KY",
            "postal_code": "41042",
            "telephone_number": "859-525-2257",
            "fax_number": "859-282-4372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRINKER",
        "first_name": "C",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "DMD PSC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "KY",
            "license": "4315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, KY

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.