Active NPI
Brady J. Neugebauer, DDS
- General Practice Dentistry
- Reno, NV
National Provider Identifier
1689763013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4051
- Practice address
- 475 Kirman Ave
Reno, NV 89502-1907 - Phone
- (775) 786-3411
- Fax
- (775) 786-3608
- NPI assigned
- Oct 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4051 | NV | Primary |
Addresses
Primary practice location
475 Kirman Ave
Reno, NV 89502-1907
Mailing address
475 Kirman Ave
Reno, NV 89502-1907
Phone (775) 786-3411
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 |
|---|---|---|---|
| 4051 | NV | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689763013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 KIRMAN AVE",
"city": "RENO",
"state": "NV",
"postal_code": "895021907",
"telephone_number": "775-786-3411",
"fax_number": "775-786-3608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 KIRMAN AVE",
"city": "RENO",
"state": "NV",
"postal_code": "895021907",
"telephone_number": "775-786-3411",
"fax_number": "775-786-3608"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEUGEBAUER",
"first_name": "BRADY",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NV",
"license": "4051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.