William John Brim, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN23263 Issued in FL

Practice address

1536 N Jefferson St
Jacksonville, FL 32209-6525

Phone

(904) 675-6230

NPI assigned

Aug 8, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Nicholas a. Narducci, DMD, PA.

  • Preferred Provider Organization
  • Jacksonville, FL
  • NPI 1194991372
  NPD (past)

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

{
    "created_epoch": "1407456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637107200000",
    "number": "1609285113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1536 N JEFFERSON ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096525",
            "telephone_number": "904-675-6230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIM",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-08",
        "last_updated": "2021-11-17",
        "certification_date": "2021-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN23263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katlyn Hermones Brigman, MA
• Kayla Rochelle Brigman
• Tonya Cheyenne Wallick Brigman, ARNP
• Kayla Brigmond, BCBA
• Jason Bradley Brill, M.D.
• Brandi Gilchrist Brimblecom, M.D.
• Jordan Alise Bringedahl, MD
• Todd G Bringhurst, D.M.D.
• Audrey Bringman
• Laura Brink

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2021; 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.