Individual provider Active NPI

Michael A. Brossman, DMD

  • Dentist
  • Green Bay, WI
National Provider Identifier
1770835969
Registry record updated Jul 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6001465 Issued in WI
Practice address
1052 Bel Aire CT
Green Bay, WI 54304-5014
Phone
(920) 499-2121
NPI assigned
Oct 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Dentist 122300000X 6001465 WI Primary

Addresses

Primary practice location

1052 Bel Aire CT
Green Bay, WI 54304-5014

Mailing address

1052 Bel Aire CT
Green Bay, WI 54304-5014
Phone (920) 499-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6001465WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Dental Center, PC Dentist Past Accepting new patients
Perfect Teeth / Abc P.C. Dentist Past Accepting new patients
Sleep Health Wisconsin LLC Dentist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1349913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784419200000",
    "number": "1770835969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1052 BEL AIRE CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045014",
            "telephone_number": "920-499-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1052 BEL AIRE CT",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045014",
            "telephone_number": "920-499-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROSSMAN",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-11",
        "last_updated": "2026-07-19",
        "certification_date": "2026-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2026; 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.