Individual provider Active NPI

Veronica Brassea, DDS

  • Dentist
  • Indio, CA
National Provider Identifier
1467509729
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
50445 Issued in CA
Practice address
82 204 Hwy 111
Ste a
Indio, CA 92201
Phone
(760) 775-5552
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 50445 CA Primary

Addresses

Primary practice location

82 204 Hwy 111
Ste a
Indio, CA 92201

Mailing address

82 204 Hwy 111
Ste a
Indio, CA 92201
Phone (760) 775-5552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160415001828 CA Order and Referring Only - DentistPractitioner - Dentist 1254639719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
50445CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Elvia Juarez a Dental Corporation Past Accepting new patients

Organizations & group practices 1

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467509729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 204 HWY 111",
            "address_2": "STE A",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "92201",
            "telephone_number": "760-775-5552",
            "fax_number": "760-775-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 204 HWY 111",
            "address_2": "STE A",
            "city": "INDIO",
            "state": "CA",
            "postal_code": "92201",
            "telephone_number": "760-775-5552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRASSEA",
        "first_name": "VERONICA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "50445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indio, CA

Sources for this page

Verify at the official NPI Registry.