Patrick Brain, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5624573-9924 Issued in UT

Practice address

11400 South 1030 East
Suite C
Sandy, UT 84094

Phone

(801) 572-0100

Fax

(801) 572-1922

NPI assigned

Mar 28, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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)

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.

• Kyle S Christensen, DDS, PC

  dba Wasatch Oral Surgery

  • Oral & Maxillofacial Surgery (D.M.D.)
  • South Jordan, UT
  • NPI 1669662425

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689793994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11400 SOUTH 1030 EAST",
            "address_2": "SUITE C",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "84094",
            "telephone_number": "801-572-0100",
            "fax_number": "801-572-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11400 SOUTH 1030 EAST",
            "address_2": "SUITE C",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "84094",
            "telephone_number": "801-572-0100",
            "fax_number": "801-572-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAIN",
        "first_name": "PATRICK",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "5624573-9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Sandy, UT
• Providers in Sandy, UT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Utah

• 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.

Verify at the official NPI Registry.