Individual provider Active NPI

Brandon Freeland, DDS

  • Pediatric Dentistry
  • Endicott, NY
National Provider Identifier
1427442995
Registry record updated Sep 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
059303 Issued in NY
Practice address
1700 Monroe St
Endicott, NY 13760-5512
Phone
(607) 953-4445
Fax
(607) 953-4634
NPI assigned
Mar 23, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 059303 NY Primary

Addresses

Primary practice location

1700 Monroe St
Endicott, NY 13760-5512

Mailing address

1700 Monroe St
Endicott, NY 13760-5512
Phone (607) 953-4445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20151228000290 MI Order and Referring Only - DentistPractitioner - Dentist 4486955051

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
059303NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dinosaur Orthodontics PLLC CurrentSince Nov 5, 2023 Accepting new patients
Tunison and Campbell Dentistry PLLC Pediatric Dentistry Past Accepting new patients

Locations

1700 Monroe St
Endicott, NY 13760
Phone (607) 754-2217

Organizations & group practices 2

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": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1427442995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 MONROE ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605512",
            "telephone_number": "607-953-4445",
            "fax_number": "607-953-4634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 MONROE ST",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137605512",
            "telephone_number": "607-953-4445",
            "fax_number": "607-953-4634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREELAND",
        "first_name": "BRANDON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-23",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "059303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endicott, NY

Sources for this page

Verify at the official NPI Registry.