Brandon Eric Devito, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7423 Issued in NC

Practice address

20 Medical Campus Dr
Suite 201
Supply, NC 28462-4096

Phone

(910) 755-6788

Fax

(910) 755-6789

NPI assigned

Sep 25, 2006

Last updated

Aug 29, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brandon E. Devito, DDS, PLLC

  dba Brunswick Family Dentistry

  • General Practice Dentistry
  • Supply, NC
  • NPI 1144321258
  NPD (past) Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1750482808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CAMPUS DR",
            "address_2": "SUITE 201",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624096",
            "telephone_number": "910-755-6788",
            "fax_number": "910-755-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MEDICAL CAMPUS DR",
            "address_2": "SUITE 201",
            "city": "SUPPLY",
            "state": "NC",
            "postal_code": "284624096",
            "telephone_number": "910-755-6788",
            "fax_number": "910-755-6789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVITO",
        "first_name": "BRANDON",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5900372",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Rudd Crichton, FNP-C
• Matthew Graham Davis, DPT
• Timothy Carr Deans
• Lauren Deluca, RN, BSN, IBCLC
• Jonathan Nicholas Desillier, PA-C
• Brenda Kay Dushek, OPA-C
• Edward E. Hayes M.D.LLC
• Essential Connections Consulting & Wellness Services LLC
• Kaitlyn Marie Etheridge
• Fayetteville Vamc

• General Practice Dentistry in Supply, NC
• Providers in Supply, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; 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.

Verify at the official NPI Registry.