Active NPI
Carl Justin Brisendine, L.D.
- Denturist
- Kalispell, MT
National Provider Identifier
1487905931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Denturist
- License
- 4206
- Practice address
- 6 Sunset PLZ
Suite C
Kalispell, MT 59901-3608 - Phone
- (406) 752-3733
- Fax
- (406) 752-3734
- NPI assigned
- Sep 24, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Denturist | 122400000X | 4206 | MT | Primary |
Addresses
Primary practice location
6 Sunset PLZ
Suite C
Kalispell, MT 59901-3608
Mailing address
6 Sunset PLZ
Suite C
Kalispell, MT 59901-3608
Phone (406) 752-3733
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4206 | MT | MD | Denturist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BC Restorations Inc | Denturist | Current | Accepting new patients |
Locations
6 Sunset Plz
Ste C
Kalispell, MT 59901
Phone (406) 752-3733
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.
-
- Denturist
- Kalispell, MT
- NPI 1376941096
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348444800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370822400000",
"number": "1487905931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 SUNSET PLZ",
"address_2": "SUITE C",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599013608",
"telephone_number": "406-752-3733",
"fax_number": "406-752-3734"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 SUNSET PLZ",
"address_2": "SUITE C",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599013608",
"telephone_number": "406-752-3733",
"fax_number": "406-752-3734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISENDINE",
"first_name": "CARL",
"middle_name": "JUSTIN",
"name_prefix": "Mr.",
"credential": "L.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-24",
"last_updated": "2013-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "122400000X",
"taxonomy_group": "",
"desc": "Denturist",
"state": "MT",
"license": "4206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.