Elizabeth Ann Brereton, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

000905496 Issued in CO

Practice address

715 Cedar Street
Buena Vista, CO 81211

Phone

(719) 395-2402

NPI assigned

Aug 31, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1760102677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29135 COUNTY ROAD 331",
            "city": "BUENA VISTA",
            "state": "CO",
            "postal_code": "812118818",
            "telephone_number": "303-521-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 CEDAR STREET",
            "city": "BUENA VISTA",
            "state": "CO",
            "postal_code": "81211",
            "telephone_number": "719-395-2402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRERETON",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "000905496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Garrett Bowdle, DPT
• Brooke N Bowen, HAD
• Joshua Brown, MA LPC, NCC
• Buena Vista Physical Therapy, LLC
• Buena Vista School District R-31
• Brooke Bundick, LPC
• Jo Caissie

• Dental Hygienist in Buena Vista, CO
• Providers in Buena Vista, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.