Individual provider Active NPI

Arliss L Brend, DDS

  • Dentist
  • Bismarck, ND
National Provider Identifier
1629028717
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1615 Issued in ND
Practice address
810 E Rosser Ave
Suite 405
Bismarck, ND 58501-4463
Phone
(701) 222-4111
Fax
(701) 222-3495
NPI assigned
May 11, 2006
Last updated
Oct 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1615 ND Primary

Addresses

Primary practice location

810 E Rosser Ave
Suite 405
Bismarck, ND 58501-4463

Mailing address

207 E Front Ave
Suite C
Bismarck, ND 58504-5596
Phone (701) 222-4111

Other identifiers 3

IdentifierTypeStateIssuer
ND1615OtherNDBLUE CROSS BLUE SHIELD OF ND
40007MedicaidND
793983OtherUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1615NDMDAudiologist

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318291200000",
    "number": "1629028717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 E FRONT AVE",
            "address_2": "SUITE C",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045596",
            "telephone_number": "701-222-4111",
            "fax_number": "701-222-3495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 E ROSSER AVE",
            "address_2": "SUITE 405",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585014463",
            "telephone_number": "701-222-4111",
            "fax_number": "701-222-3495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREND",
        "first_name": "ARLISS",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2011-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "1615",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ND",
            "identifier": "ND1615",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40007",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "793983",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.