Active NPI
Brian Joseph Fernandes, DDS
- Dentist
- West Palm Beach, FL
National Provider Identifier
1710360854
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN27543
- Practice address
- 3027 Forest Hill Blvd Ste A3
West Palm Beach, FL 33406-5934 - Phone
- (561) 571-0453
- NPI assigned
- Jul 7, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 058733 | NY | |
| Dentist | 122300000X | 103750 | CA | |
| Dentist | 122300000X | DN27543 | FL | Primary |
Addresses
Primary practice location
3027 Forest Hill Blvd Ste A3
West Palm Beach, FL 33406-5934
Mailing address
9307 Firenze Dr Apt 101
Palm Beach Gardens, FL 33418-8145
Phone (175) 787-0266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20221102002749 | CA | Order and Referring Only - Dentist | 8729455845 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN27543 | FL | MD | Dentist |
| 058733 | NY | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Center of Richmond, Inc | Past | Accepting new patients |
Networks
- Freedom Health HMO Network
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Staten Island, NY
- NPI 1114137403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705449600000",
"number": "1710360854",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9307 FIRENZE DR APT 101",
"city": "PALM BEACH GARDENS",
"state": "FL",
"postal_code": "334188145",
"telephone_number": "175-787-0266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3027 FOREST HILL BLVD STE A3",
"city": "WEST PALM BEACH",
"state": "FL",
"postal_code": "334065934",
"telephone_number": "561-571-0453"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDES",
"first_name": "BRIAN",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-07",
"last_updated": "2024-01-17",
"certification_date": "2024-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "058733",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "103750",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "FL",
"license": "DN27543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Palm Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.