NPIMap

Organization Active NPI

Donald J. Brockriede, D.D.S., P.C.

  • Dental Clinic/Center
  • North Branch, MI
National Provider Identifier
1598977795
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2901010543 Issued in MI
Legal business name
DONALD J. BROCKRIEDE, D.D.S., P.C.
Practice address
3720 Huron St
North Branch, MI 48461-8117
Phone
(810) 688-3008
Fax
(810) 688-2429
NPI assigned
May 3, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Donald Joe Brockriede, D.D.S.NPI 1285846451
Title
Officer
Phone
(810) 688-3008

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2901010543 MI Primary

Addresses

Primary practice location

3720 Huron St
North Branch, MI 48461-8117

Mailing address

PO Box 707
North Branch, MI 48461-0707
Phone (810) 688-3008

Other identifiers 2

IdentifierTypeStateIssuer
D105430OtherMIBCBS OF MICH. DENTAL PROV
5446023OtherMIBCBS MEDICAL PROVIDER

National Provider Directory

National Provider Directory

Locations

3720 Huron St
North Branch, MI 48461
Phone (810) 688-3008

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1598977795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 707",
            "city": "NORTH BRANCH",
            "state": "MI",
            "postal_code": "484610707",
            "telephone_number": "810-688-3008",
            "fax_number": "810-688-2429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 HURON ST",
            "city": "NORTH BRANCH",
            "state": "MI",
            "postal_code": "484618117",
            "telephone_number": "810-688-3008",
            "fax_number": "810-688-2429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD J. BROCKRIEDE, D.D.S., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROCKRIEDE",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "JOE",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "810-688-3008",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MI",
            "license": "2901010543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICH. DENTAL PROV",
            "identifier": "D105430",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MEDICAL PROVIDER",
            "identifier": "5446023",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Branch, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.