Bruce A Brandolin, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

039187 Issued in NY

Practice address

45 Wellington CT
Yorktown Heights, NY 10598-5923

Phone

(914) 907-5187

NPI assigned

May 10, 2007

Last updated

Aug 9, 2021By 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

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.

Opted out of Medicare

Yes, effective Jun 30, 2015 through Jun 30, 2027

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1669686176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WELLINGTON CT",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105985923",
            "telephone_number": "914-907-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WELLINGTON CT",
            "city": "YORKTOWN HEIGHTS",
            "state": "NY",
            "postal_code": "105985923",
            "telephone_number": "914-907-5187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDOLIN",
        "first_name": "BRUCE",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "039187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John A Boday
• Shanique Tsige Bowden
• Terita June Bradoc, LMT, CIR
• Amber Leah Brady, PTA
• Margaret V Brady, FNP
• Cynthia Strand Braun, MD
• Mark G Brauning, MD
• Jack Leon Brenner, MD
• Bridges 4 Independence, LLC
• Brightway Dental PC (Brightway Dental)

• Dentist in Yorktown Heights, NY
• Providers in Yorktown Heights, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.