Active NPI
Mark Edward Brennan, D.D.S.
- Prosthodontics
- Westminster, MD
National Provider Identifier
1598033136
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 11743
- Practice address
- 882 Backbone CT
Westminster, MD 21157-7745 - Phone
- (410) 751-8886
- NPI assigned
- Dec 11, 2011
- 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 |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 11743 | MD | Primary |
Addresses
Primary practice location
882 Backbone CT
Westminster, MD 21157-7745
Mailing address
882 Backbone CT
Westminster, MD 21157-7745
Phone (410) 751-8886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160122001104 | MD | Order and Referring Only - Dentist | 2668514647 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11743 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323561600000",
"number": "1598033136",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "882 BACKBONE CT",
"city": "WESTMINSTER",
"state": "MD",
"postal_code": "211577745",
"telephone_number": "410-751-8886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "882 BACKBONE CT",
"city": "WESTMINSTER",
"state": "MD",
"postal_code": "211577745",
"telephone_number": "410-751-8886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRENNAN",
"first_name": "MARK",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-12-11",
"last_updated": "2011-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MD",
"license": "11743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westminster, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2011; 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.