Breanne Mumm-Reed

Key facts

NPI

1760835474

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

DDS-09318 (IA)

Practice address

55 State St
Garner, IA 50438-1108

Phone

(641) 923-3771

NPI assigned

Jul 18, 2016

Sex

Female

Sole proprietor

No

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.

• DRS. Tesene, Maurer and Maurer,DDS, PC General Practice Dentistry · Garner, IA · NPI 1487687919
  NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Opted out of Medicare

Yes, effective Jun 1, 2018 through Jun 1, 2028

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 18, 2016.

{
    "created_epoch": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1760835474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 STATE ST",
            "city": "GARNER",
            "state": "IA",
            "postal_code": "504381108",
            "telephone_number": "641-923-3771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 STATE ST",
            "city": "GARNER",
            "state": "IA",
            "postal_code": "504381108",
            "telephone_number": "641-923-3771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMM-REED",
        "first_name": "BREANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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