Individual provider Active NPI

Brett Thomas Laggan, D.D.S.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Pensacola, FL
National Provider Identifier
1629049507
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
DN18924 Issued in FL
Practice address
121 Baptist Way Ste 1100
Pensacola, FL 32503-2254
Phone
(850) 478-7070
Fax
(850) 476-2513
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30021027 OH
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN18924 FL
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X DN18924 FL Primary

Addresses

Primary practice location

121 Baptist Way Ste 1100
Pensacola, FL 32503-2254

Mailing address

121 Baptist Way Ste 1100
Pensacola, FL 32503-2254
Phone (850) 478-7070

Other identifiers 1

IdentifierTypeStateIssuer
076708500MedicaidFL

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160323001929 FL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1052618741

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30021027OHMDOral and Maxillofacial Surgery (Dentist)

Interoperability endpoints

  • Direct secure messaging: brett.laggan.1@24790.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1629049507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 BAPTIST WAY STE 1100",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032254",
            "telephone_number": "850-478-7070",
            "fax_number": "850-476-2513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BAPTIST WAY STE 1100",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032254",
            "telephone_number": "850-478-7070",
            "fax_number": "850-476-2513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGGAN",
        "first_name": "BRETT",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30021027",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18924",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "FL",
            "license": "DN18924",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076708500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

Verify at the official NPI Registry.