Active NPI
Brian John Normile, DDS
- General Practice Dentistry
- Apo, AL
National Provider Identifier
1700319266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 30.025192
- Practice address
- 374 MDG Dental Clinic
Yokota Ab
Apo, AL 96326 - Phone
- (315) 225-3671
- NPI assigned
- Apr 11, 2017
- Last updated
- Oct 24, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 30.025192 | OH | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
374 MDG Dental Clinic
Yokota Ab
Apo, AL 96326
Mailing address
4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433-5529
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 |
|---|---|---|---|
| 30.025192 | OH | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666569600000",
"number": "1700319266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4881 SUGAR MAPLE DR",
"city": "WRIGHT PATTERSON AFB",
"state": "OH",
"postal_code": "454335529"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "374 MDG DENTAL CLINIC",
"address_2": "YOKOTA AB",
"city": "APO",
"state": "AL",
"postal_code": "96326",
"telephone_number": "315-225-3671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NORMILE",
"first_name": "BRIAN",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-04-11",
"last_updated": "2022-10-24",
"certification_date": "2022-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OH",
"license": "30.025192",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Apo, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.