Individual provider Active NPI

Christian Andrew Brandyberry, D.M.D.

  • General Practice Dentistry
  • Thomasville, NC
National Provider Identifier
1689731168
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7959 Issued in NC
Practice address
1602 Liberty Drive
Thomasville, NC 27360-5750
Phone
(336) 475-8181
NPI assigned
Jan 3, 2007
Last updated
Mar 23, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7959 NC Primary

Addresses

Primary practice location

1602 Liberty Drive
Thomasville, NC 27360-5750

Mailing address

1602 Liberty Drive
Thomasville, NC 27360-5750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20140909001069 NC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3072732957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7959NCMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brandyberry & Associates, PLLC General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1689731168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 LIBERTY DRIVE",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273605750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 LIBERTY DRIVE",
            "city": "THOMASVILLE",
            "state": "NC",
            "postal_code": "273605750",
            "telephone_number": "336-475-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANDYBERRY",
        "first_name": "CHRISTIAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, NC

Sources for this page

Verify at the official NPI Registry.