Brian Darnell Collins, D.D.S.
Individual provider Active NPI Pediatric Dentistry · Middlebury, VT
NPI 1790901015 · NPPES record last updated May 3, 2014
Key facts
- NPI
- 1790901015
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 016.0077184 (VT)
- Practice address
- 1330 Exchange St
Suite 107
Middlebury, VT 05753-4464 - Phone
- (214) 642-6383
- NPI assigned
- Apr 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 04022 | NH | MD | Pediatric Dentist |
| 016.0077184 | VT | MD | Pediatric Dentist |
| 14168 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Middlebury Pediatric Dentistry, PLLC | Pediatric Dentistry | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 14168 | TX | |
| Pediatric Dentistry | 1223P0221X | 016.0077184 | VT | Yes |
| Pediatric Dentistry | 1223P0221X | 04022 | NH |
Addresses
Primary practice location
1330 Exchange St
Suite 107
Middlebury, VT 05753-4464
Mailing address
PO Box 363
Middlebury, VT 05753-0363
Phone (214) 642-6383
Other providers in Middlebury, VT
- Carl Wade Cobb
- Patrice Peterson Colander
- Arthur Thompson Colley
- Kathleen Colligan Lowell
- Brian Andrew Collins
- Columbus Medical Services, LLC
- Columbus Medical Services, LLC
- Nancy Joyce Conant
- George Martin Connelly
- Carolyn Conner
All providers in Middlebury, VT · Pediatric Dentistry in Vermont
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.