Brent C. Mackay D.D.S., a Professional Corporation

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

25588 Issued in CA

Legal business name

BRENT C. MACKAY D.D.S., A PROFESSIONAL CORPORATION

Practice address

5571 Scottwood Rd
Paradise, CA 95969-5043

Phone

(530) 877-8694

Fax

(530) 877-8038

NPI assigned

Aug 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brent Calvin Mackay, D.D.S.NPI 1275515280

Title

President

Phone

(530) 877-8694

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brent Calvin Mackay, DDS

  • Dentist
  • Paradise, CA
  • NPI 1275515280
  NPD (past) Authorized official

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187740800000",
    "number": "1710170733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5571 SCOTTWOOD RD",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959695043",
            "telephone_number": "530-877-8694",
            "fax_number": "530-877-8038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5571 SCOTTWOOD RD",
            "city": "PARADISE",
            "state": "CA",
            "postal_code": "959695043",
            "telephone_number": "530-877-8694",
            "fax_number": "530-877-8038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENT C. MACKAY D.D.S., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2007-08-22",
        "status": "A",
        "authorized_official_last_name": "MACKAY",
        "authorized_official_first_name": "BRENT",
        "authorized_official_middle_name": "CALVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-877-8694",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "25588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL DENTAL PROGRAM",
            "identifier": "B25588-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaynae Michelle Boyles
• Karen S Bradley
• Erin Lynsey Brandt
• Andrew Joseph Brasch, MD
• Stacey Lynn Bray, BSW
• Brian J Eisermann
• Christine E Brice, NP
• Amy Sofer Bromelow
• Kathy Brossard-Bird, MFT
• Amelia Jane Brown

• General Practice Dentistry in Paradise, CA
• Providers in Paradise, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.