Ericka Tisdale McBrine, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22785 Issued in TX

Practice address

101 W Creek St
Fredericksburg, TX 78624-3730

Phone

(830) 990-1178

NPI assigned

Nov 20, 2007

Last updated

Jan 19, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ericka T McBrine DDS PA

  • Dentist
  • Fredericksburg, TX
  • NPI 1861881120
  NPD (past) Authorized official
• Fred Grimes,D.D.S., Inc

  dba Creek Street Dental

  • Dentist
  • Fredericksburg, TX
  • NPI 1487925848
  NPD (past)

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326931200000",
    "number": "1467633305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W CREEK ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786243730",
            "telephone_number": "830-990-1178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W CREEK ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786243730",
            "telephone_number": "830-990-1178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRINE",
        "first_name": "ERICKA",
        "middle_name": "TISDALE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-20",
        "last_updated": "2012-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412221",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "22785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Matteson, LCSW
• Matthew J Hoermann MD PA
• Darcey M Mattson
• Jennifer Kate Mayben, M.D.
• Gary Brent Mayes, M.D.
• McCrae Management and Investments, LTD. (NewSound Hearing Aid Centers)
• Vance Andrews McDonald Jr., P.T.
• Donna Sue Lee McKellar, LPC
• Kenneth A McKellar Sr., LPC. PHD
• MD Integrative Health PLLC

• General Practice Dentistry in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2012; 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.

Verify at the official NPI Registry.