Active NPI
Matthew M Brennan, D.M.D
- Orthodontics and Dentofacial Orthopedics Dentistry
- Warwick, RI
National Provider Identifier
1538348321
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DEN2587
- Practice address
- 1434 Warwick Ave
Warwick, RI 02888-5026 - Phone
- (401) 463-6350
- NPI assigned
- Oct 29, 2007
- 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 |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DEN2587 | RI | Primary |
Addresses
Primary practice location
1434 Warwick Ave
Warwick, RI 02888-5026
Mailing address
1434 Warwick Ave
Warwick, RI 02888-5026
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 139-741 | Other | UNITED CONCORDIA | |
| 41-00012 | Other | UNITED HEALTHCARE | |
| 8037-4 | Other | BLUE CROSS | |
| WB01101 | Medicaid | RI | |
| RG0069 | Other | BLUE CROSS MASS |
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 |
|---|---|---|---|
| DEN2587 | RI | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brennan Orthodontics, Inc. | Orthodontics and Dentofacial Orthopedics | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Warwick, RI
- NPI 1336208511
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193616000000",
"number": "1538348321",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1434 WARWICK AVE",
"city": "WARWICK",
"state": "RI",
"postal_code": "028885026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1434 WARWICK AVE",
"city": "WARWICK",
"state": "RI",
"postal_code": "028885026",
"telephone_number": "401-463-6350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "MATTHEW",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-10-29",
"last_updated": "2007-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "RI",
"license": "DEN2587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "139-741",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "41-00012",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "8037-4",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "WB01101",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS MASS",
"identifier": "RG0069",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Warwick, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.