Individual provider Active NPI

James B Brennan, D.D.S.

  • Dentist
  • Grand Rapids, MI
National Provider Identifier
1619970522
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901015590 Issued in MI
Practice address
3152 Peregrine Dr NE
Ste 200
Grand Rapids, MI 49525-9723
Phone
(616) 447-3660
Fax
(616) 447-7660
NPI assigned
May 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901015590 MI Primary

Addresses

Primary practice location

3152 Peregrine Dr NE
Ste 200
Grand Rapids, MI 49525-9723

Mailing address

3152 Peregrine Dr NE
Ste 200
Grand Rapids, MI 49525-9723
Phone (616) 447-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605000098 MI Order and Referring Only - Other (Non-Physician) 5991026700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901015590MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Brennan Family & Cosmetic Dentistry, PC PastSince Mar 19, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619970522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3152 PEREGRINE DR NE",
            "address_2": "STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259723",
            "telephone_number": "616-447-3660",
            "fax_number": "616-447-7660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3152 PEREGRINE DR NE",
            "address_2": "STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259723",
            "telephone_number": "616-447-3660",
            "fax_number": "616-447-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "JAMES",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901015590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.