Active NPI
Brian Daniel Carmody, D.D.S.
- Dentist
- Plymouth, MI
National Provider Identifier
1447570544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901020199
- Practice address
- 289 W Spring St
Apt. 1
Plymouth, MI 48170-1688 - Phone
- (248) 514-2568
- NPI assigned
- Jun 11, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901020199 | MI | Primary |
Addresses
Primary practice location
289 W Spring St
Apt. 1
Plymouth, MI 48170-1688
Mailing address
289 W Spring St
Apt. 1
Plymouth, MI 48170-1688
Phone (248) 514-2568
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160202000143 | MI | Order and Referring Only - Dentist | 0143524728 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901020199 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276214400000",
"number": "1447570544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "289 W SPRING ST",
"address_2": "APT. 1",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701688",
"telephone_number": "248-514-2568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "289 W SPRING ST",
"address_2": "APT. 1",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701688",
"telephone_number": "248-514-2568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARMODY",
"first_name": "BRIAN",
"middle_name": "DANIEL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-06-11",
"last_updated": "2010-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901020199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.