Andrew Thomas Bracci, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

055288 Issued in NY

Practice address

3001 6TH St
Great Lakes, IL 60088-2833

Phone

(847) 688-2100

NPI assigned

Jan 9, 2006

Sex

Male

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Buffalo Oral Surgery Specialists PLLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Buffalo, NY
  • NPI 1609570092
  NPD Authorized official
• Suresh N Goel DDS PC

  • Periodontics
  • Pittsford, NY
  • NPI 1235260688
  NPD (past)

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1528046620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 N LASALLE ST",
            "address_2": "UNIT 1105",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606108027",
            "telephone_number": "312-502-1292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 6TH ST",
            "city": "GREAT LAKES",
            "state": "IL",
            "postal_code": "600882833",
            "telephone_number": "847-688-2100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "117 Linwood Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142092003",
            "country_code": "US",
            "telephone_number": "716-882-6333",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "151 Sullys Trl",
            "address_purpose": "LOCATION",
            "city": "Pittsford",
            "state": "NY",
            "postal_code": "145344562",
            "country_code": "US",
            "telephone_number": "585-385-4867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACCI",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "19026285",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "055288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomasz Boltruczyk, FNP-C
• Alexandra Bone
• Malayah Booker, BT
• Steven C Bourgeois, MA, CCC-A
• Joseph Boyer
• Rebecca Anne Braden, DDS
• Zachary Breen, DDS
• Neil Bresnahan, D.D.S.
• Kevin Potter Brown, PH.D.
• Gregory C Browning, DDS

• Oral and Maxillofacial Surgery (Dentist) in Great Lakes, IL
• Providers in Great Lakes, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.