Active NPI
Carmen D. Brambila, D.M.D.
- Pediatric Dentistry
- Waltham, MA
National Provider Identifier
1801043138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN1856140
- Practice address
- 695 Main St
Waltham, MA 02451-0609 - Phone
- (781) 899-7070
- Fax
- (781) 899-1802
- NPI assigned
- Aug 18, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DN1856140 | MA | |
| Pediatric Dentistry | 1223P0221X | DN1856140 | MA | Primary |
Addresses
Primary practice location
695 Main St
Waltham, MA 02451-0609
Mailing address
695 Main St
Waltham, MA 02451-0609
Phone (781) 899-7070
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110098455A | Medicaid | MA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN1856140 | MA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Dental of Waltham, P.C. | Past | Accepting new patients |
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.
-
- General Practice Dentistry
- Waltham, MA
- NPI 1184768426
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1426809600000",
"number": "1801043138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "695 MAIN ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024510609",
"telephone_number": "781-899-7070",
"fax_number": "781-899-1802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "695 MAIN ST",
"city": "WALTHAM",
"state": "MA",
"postal_code": "024510609",
"telephone_number": "781-899-7070",
"fax_number": "781-899-1802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAMBILA",
"first_name": "CARMEN",
"middle_name": "D.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-18",
"last_updated": "2015-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN1856140",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "MA",
"license": "DN1856140",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110098455A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.