Active NPI
Tayler Brinson
- General Practice Dentistry
- Augusta, GA
National Provider Identifier
1639637507
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN015901
- Practice address
- 1430 John Wesley Gilbert Drive
Augusta, GA 30912-1704 - Phone
- (706) 723-4506
- NPI assigned
- Mar 8, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DN015901 | GA | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | DN015901 | GA |
Addresses
Primary practice location
1430 John Wesley Gilbert Drive
Augusta, GA 30912-1704
Mailing address
440 Westhaven CT
Grovetown, GA 30813-0760
Phone (912) 293-7582
Other practice location 1
440 Westhaven Ct
Grovetown, GA 30813-0760
Phone (912) 293-7582
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DN015901 | Other | GA | DENTAL LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN015901 | GA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734566400000",
"number": "1639637507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "440 WESTHAVEN CT",
"city": "GROVETOWN",
"state": "GA",
"postal_code": "308130760",
"telephone_number": "912-293-7582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1430 JOHN WESLEY GILBERT DRIVE",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309121704",
"telephone_number": "706-723-4506"
}
],
"practiceLocations": [
{
"address_1": "440 Westhaven Ct",
"address_purpose": "LOCATION",
"city": "Grovetown",
"state": "GA",
"postal_code": "308130760",
"country_code": "US",
"telephone_number": "912-293-7582",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRINSON",
"first_name": "TAYLER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-08",
"last_updated": "2024-12-19",
"certification_date": "2024-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "DN015901",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "GA",
"license": "DN015901",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "DN015901",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.