Corey J Brenner DDS PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D11525 Issued in MN

Legal business name

COREY J BRENNER DDS PLLC

Practice address

9000 Walnut St
Box 236
Rockford, MN 55373-0236

Phone

(763) 477-5794

Fax

(763) 477-4784

NPI assigned

Sep 24, 2008

Last updated

Jun 19, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Corey James Brenner, DDSNPI 1134106818

Title

Owner

Phone

(763) 477-5794

Specialties & licenses 1

Addresses

Other names 1

• Rockford Dentalcare Center Former legal business name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Corey J Brenner, DDS

  • General Practice Dentistry
  • Rockford, MN
  • NPI 1134106818
  NPD (past) Authorized official

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560902400000",
    "number": "1689824898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8900 WALNUT ST SUITE 450 BOX 236",
            "city": "ROCKFORD",
            "state": "MN",
            "postal_code": "553730236",
            "telephone_number": "763-477-5794",
            "fax_number": "763-477-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 WALNUT ST",
            "address_2": "BOX 236",
            "city": "ROCKFORD",
            "state": "MN",
            "postal_code": "553730236",
            "telephone_number": "763-477-5794",
            "fax_number": "763-477-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COREY J BRENNER DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2019-06-19",
        "status": "A",
        "authorized_official_last_name": "BRENNER",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-477-5794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D11525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockford Dentalcare Center",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Rockford Dentalcare Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Hannah Rose Buffie, ND
• Perry Buffie, D.C.
• Richard Carroll Burleson, LPCC
• Caring Hearts at Home, LLC
• Amanda Carlen
• VI Doan
• Domi Services Incorporated
• Ann I Fromell-Theis, DDS
• Gehlen Counseling and Consulting LLC (Transformational Therapy Services)
• Kacie Crowell Green, DDS

• Dental Clinic/Center in Rockford, MN
• Providers in Rockford, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; 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.