Active NPI
Yetunde Braithwaite, DDS
- Dentist
- Richmond, IN
National Provider Identifier
1497534200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 12014212A
- Practice address
- 520 S 9TH St Ste a
Richmond, IN 47374-6230 - Phone
- (765) 935-5390
- Fax
- (765) 935-5392
- NPI assigned
- Sep 22, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 12014212A | IN | Primary |
Addresses
Primary practice location
520 S 9TH St Ste a
Richmond, IN 47374-6230
Mailing address
240 N Tillotson Ave
Muncie, IN 47304-3988
Phone (765) 288-1928
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 |
|---|---|---|---|
| 12014212A | IN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Health Services Corp | Past | Accepting new patients |
Interoperability endpoints
- yetunde.braithwaite.p1@direct.meridianhs.nextgenshare.com
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.
-
- Federally Qualified Health Center (FQHC)
- Richmond, IN
- NPI 1578194049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1695340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695340800000",
"number": "1497534200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 N TILLOTSON AVE",
"city": "MUNCIE",
"state": "IN",
"postal_code": "473043988",
"telephone_number": "765-288-1928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S 9TH ST STE A",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473746230",
"telephone_number": "765-935-5390",
"fax_number": "765-935-5392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAITHWAITE",
"first_name": "YETUNDE",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-22",
"last_updated": "2023-09-22",
"certification_date": "2023-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IN",
"license": "12014212A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.