Individual provider Active NPI

Brent Ellis Parrott, D.D.S.

  • General Practice Dentistry
  • Oroville, CA
National Provider Identifier
1457447278
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
C46921 Issued in CA
Practice address
2014 5TH Ave
Oroville, CA 95965-5815
Phone
(530) 533-8204
Fax
(530) 533-3161
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X AZ4666 AZ
General Practice Dentistry 1223G0001X C46921 CA Primary

Addresses

Primary practice location

2014 5TH Ave
Oroville, CA 95965-5815

Mailing address

22450 S 201St CT
Queen Creek, AZ 85142-6311
Phone (530) 966-5335

Other identifiers 5

IdentifierTypeStateIssuer
1457447278OtherNPI
1467179325OtherNPI
86-0939087OtherAZFEDERAL BUSINESS ID
07-549561-VOtherAZSTATE BUSINESS ID
1942687215OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Dec 16, 2015 through Dec 16, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46921CAMDMarriage & Family Therapist
AZ4666AZMDGeneral Practice Dentistry
C46921CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
It'S Your Time Dental General Practice CurrentSince Oct 23, 2022 Accepting new patients
Brent E Parrott DDS Inc General Practice Past Accepting new patients

Locations

21295 S Ellsworth Loop Rd
Ste 103
Queen Creek, AZ 85142
Phone (480) 445-9188

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1457447278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22450 S 201ST CT",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426311",
            "telephone_number": "530-966-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 5TH AVE",
            "city": "OROVILLE",
            "state": "CA",
            "postal_code": "959655815",
            "telephone_number": "530-533-8204",
            "fax_number": "530-533-3161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARROTT",
        "first_name": "BRENT",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "AZ4666",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "C46921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1457447278",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467179325",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BUSINESS ID",
            "identifier": "86-0939087",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE BUSINESS ID",
            "identifier": "07-549561-V",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1942687215",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oroville, CA

Sources for this page

Verify at the official NPI Registry.