Chad Brantly, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

27156 Issued in TX

Practice address

2149 Office Park Dr
San Angelo, TX 76904-6803

Phone

(325) 949-9668

Fax

(325) 949-0422

NPI assigned

Aug 16, 2011

Last updated

Aug 16, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Root Canal Specialists PLLC

  • Dental Clinic/Center
  • San Angelo, TX
  • NPI 1588309546
  NPD Authorized official

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1659651081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2149 OFFICE PARK DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046803",
            "telephone_number": "325-949-9668",
            "fax_number": "325-949-0422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2149 OFFICE PARK DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046803",
            "telephone_number": "325-949-9668",
            "fax_number": "325-949-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANTLY",
        "first_name": "CHAD",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "27156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Bragg, LAT, ATC
• Tiffany Branam, LCSW
• Jacob Brandon, L.A.T.
• Whitney Brandon, CO/LPO
• Holly D Brannan, LPC
• James Warren Brasher, O.D.
• Anthony Bray, PHARMD, RPH
• Susan Brayton, ACNPC-AG
• Breakthrough Therapy & Services LLC
• Garrett Breedlove, PHARM D

• General Practice Dentistry in San Angelo, TX
• Providers in San Angelo, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.