NPIMap

Organization Active NPI

Melissa Brandner Prof. LLC

  • Dentist
  • Tea, SD
National Provider Identifier
1518355841
Registry record updated Jan 9, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MELISSA BRANDNER PROF. LLC
Doing business as
Parkside Dental
Practice address
910 N Main Ave
Suite 101
Tea, SD 57064-0580
Phone
(605) 498-4746
Fax
(605) 498-9012
NPI assigned
Jan 9, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2015

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

Authorized official

Name
Dr. Melissa Ann Brandner, D.D.S.
Title
Owner
Phone
(605) 498-4746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

910 N Main Ave
Suite 101
Tea, SD 57064-0580

Mailing address

PO Box 580
Tea, SD 57064-0580
Phone (605) 498-4746

Other names 1

  • Parkside Dental Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1420761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420761600000",
    "number": "1518355841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 580",
            "city": "TEA",
            "state": "SD",
            "postal_code": "570640580",
            "telephone_number": "605-498-4746",
            "fax_number": "605-498-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 N MAIN AVE",
            "address_2": "SUITE 101",
            "city": "TEA",
            "state": "SD",
            "postal_code": "570640580",
            "telephone_number": "605-498-4746",
            "fax_number": "605-498-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA BRANDNER PROF. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-09",
        "last_updated": "2015-01-09",
        "status": "A",
        "authorized_official_last_name": "BRANDNER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "605-498-4746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Parkside Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tea, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.