Individual provider Active NPI

Christopher S Brendemuhl, DMD

  • General Practice Dentistry
  • Phoenix, AZ
National Provider Identifier
1780872390
Registry record updated Jan 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D7404 Issued in AZ
Practice address
1101 N Central Ave Ste 106
Phoenix, AZ 85004-1808
Phone
(602) 344-8717
Fax
(602) 344-8722
NPI assigned
Oct 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D7404 AZ Primary

Addresses

Primary practice location

1101 N Central Ave Ste 106
Phoenix, AZ 85004-1808

Mailing address

PO Box 29670
Phoenix, AZ 85038-9670
Phone (602) 344-8181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20230523001302 AZ Practitioner - Dentist 8123321676 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D7404AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Maricopa County Special Health Care District CurrentSince May 15, 2023 Accepting new patients
Maricopa County Special Health Care District Current Accepting new patients
Maricopa County Special Health Care District CurrentSince May 15, 2023 Accepting new patients

Locations

950 E Van Buren St
Avondale, AZ 85323
Phone (623) 344-6800

5141 W Lamar Rd
Glendale, AZ 85301
Phone (602) 506-6767

59 S Hibbert
Mesa, AZ 85210
Phone (480) 344-6200

8088 W Whitney Dr
Peoria, AZ 85345
Phone (602) 655-2000

33 W Tamarisk St
Phoenix, AZ 85041
Phone (602) 344-6400

1101 N Central Ave
Ste 106
Phoenix, AZ 85004
Phone (602) 344-8717

2525 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 344-1015

2601 E Roosevelt St
Phoenix, AZ 85008
Phone (602) 220-0298

Interoperability endpoints

  • Direct secure messaging: cbrendemuhl2068@direct.valleywisehealth.org

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": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1780872390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29670",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850389670",
            "telephone_number": "602-344-8181",
            "fax_number": "602-344-8122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CENTRAL AVE STE 106",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041808",
            "telephone_number": "602-344-8717",
            "fax_number": "602-344-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENDEMUHL",
        "first_name": "CHRISTOPHER",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-09",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D7404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.