NPIMap

Organization Active NPI

Brannick D Adams DDS PC

Doing business as Harvard Dental Group

  • General Practice Dentistry
  • Roseburg, OR
National Provider Identifier
1437475704
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8590 Issued in OR
Legal business name
BRANNICK D ADAMS DDS PC
Doing business as
Harvard Dental Group
Practice address
1539 W Harvard Ave
Roseburg, OR 97471-2873
Phone
(541) 673-5150
NPI assigned
Apr 12, 2010
Last updated
Apr 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2010

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

Authorized official

Name
Dr. Brannick D AdamsNPI 1376577700
Title
Denist/President
Phone
(541) 673-5150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8590 OR Primary

Addresses

Primary practice location

1539 W Harvard Ave
Roseburg, OR 97471-2873

Mailing address

1539 W Harvard Ave
Roseburg, OR 97471-2873
Phone (541) 673-5150

Other identifiers 1

IdentifierTypeStateIssuer
213541MedicaidOR

Other names 1

  • Harvard Dental Group Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1437475704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1539 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712873",
            "telephone_number": "541-673-5150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1539 W HARVARD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712873",
            "telephone_number": "541-673-5150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANNICK D ADAMS DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-12",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "BRANNICK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENIST/PRESIDENT",
        "authorized_official_telephone_number": "541-673-5150",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "8590",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213541",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Harvard Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2010; 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.