Active NPI
Brett Page, D.M.D.
- Dentist
- San Diego, CA
National Provider Identifier
1720494297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN014783
- Practice address
- 2310 Craven St
San Diego, CA 92136-5596 - Phone
- (619) 556-8229
- Fax
- (619) 556-8289
- NPI assigned
- Jul 6, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN014783 | GA | Primary |
Addresses
Primary practice location
2310 Craven St
San Diego, CA 92136-5596
Mailing address
2310 Craven St
San Diego, CA 92136-5596
Phone (619) 556-8229
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- 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 |
|---|---|---|---|---|
| I20240522002591 | WA | Order and Referring Only - Oral and Maxillofacial Radiology | 1658713672 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN014783 | GA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406678400000",
"number": "1720494297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 CRAVEN ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921365596",
"telephone_number": "619-556-8229",
"fax_number": "619-556-8289"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 CRAVEN ST",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921365596",
"telephone_number": "619-556-8229",
"fax_number": "619-556-8289"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAGE",
"first_name": "BRETT",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-06",
"last_updated": "2014-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "DN014783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; 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.