Active NPI
Brent Ellis Parrott, D.D.S.
- General Practice Dentistry
- Oroville, CA
National Provider Identifier
1457447278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- C46921
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457447278 | Other | NPI | |
| 1467179325 | Other | NPI | |
| 86-0939087 | Other | AZ | FEDERAL BUSINESS ID |
| 07-549561-V | Other | AZ | STATE BUSINESS ID |
| 1942687215 | Other | NPI |
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
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 46921 | CA | MD | Marriage & Family Therapist |
| AZ4666 | AZ | MD | General Practice Dentistry |
| C46921 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| It'S Your Time Dental | General Practice | Current | 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.
-
- General Practice Dentistry
- Queen Creek, AZ
- NPI 1467179325
-
- General Practice Dentistry
- Oroville, CA
- NPI 1942687215
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.