Jordan Brenner DDS, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60291757 Issued in WA

Legal business name

JORDAN BRENNER DDS, PLLC

Practice address

1359 N 205TH St
Suite a
Shoreline, WA 98133-3215

Phone

(206) 533-9693

Fax

(206) 533-9691

NPI assigned

Jun 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jordan McDonald Brenner, D.D.S.NPI 1902152887

Title

Dentist

Phone

(563) 271-9529

Specialties & licenses 1

Addresses

Other names 1

• Bright 32 Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jordan M Brenner, D.D.S.

  • Dentist
  • Shoreline, WA
  • NPI 1902152887
  NPD (past) Authorized official
• Ekaterina Malinovska, D.D.S.

  • Dentist
  • Shoreline, WA
  • NPI 1912328758
  NPD (past)

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1609289073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1359 N 205TH ST",
            "address_2": "SUITE A",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333215",
            "telephone_number": "206-533-9693",
            "fax_number": "206-533-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1359 N 205TH ST",
            "address_2": "SUITE A",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333215",
            "telephone_number": "206-533-9693",
            "fax_number": "206-533-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JORDAN BRENNER DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "MCDONALD",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "563-271-9529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60291757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bright 32",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jacky Dean Jones, PT, DPT
• Kres M Jones
• Rachel Jones, DOULA
• Richard T. Jones, DDS
• John Yohan Joo, D.P.M
• Jorge Alexander Florez
• Jack J Jorgenson, MD
• Josiah Health Services LLC
• Nicholas G Jzyk, MD LMHCA
• Charlene Kaiser

• General Practice Dentistry in Shoreline, WA
• Providers in Shoreline, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.