John Brothers, D.D.S., M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

104747 Issued in CA

Practice address

3771 W 242ND St Ste 102
Torrance, CA 90505-6566

Phone

(310) 373-7773

Fax

(310) 373-7771

NPI assigned

Apr 22, 2015

Last updated

Jan 26, 2022By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 19, 2021 through Oct 19, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: tbrothers45973@direct.phhs.org

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643155200000",
    "number": "1760879126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3771 W 242ND ST STE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056566",
            "telephone_number": "310-373-7773",
            "fax_number": "310-373-7771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3771 W 242ND ST STE 102",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905056566",
            "telephone_number": "310-373-7773",
            "fax_number": "310-373-7771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERS",
        "first_name": "JOHN",
        "credential": "D.D.S., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-22",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "CA",
            "license": "175649",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "104747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reanna Bromley
• David Bronstein
• Melanie Smith Bronstein, N.P.
• Lavena Brooks
• Zachariah Brosz
• Kristin Brothers, D.D.S.
• Joy Brotherton, MD
• Valerie Browers, LEP, PHD
• Nichole Denise Brown-Moon
• Charlise Brown-Scranton, RN

• Oral and Maxillofacial Surgery (Dentist) in Torrance, CA
• Providers in Torrance, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.