Carl Edward Branyan, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901008455 Issued in MI

Practice address

Clinica Santa Maria 730 Grandville Ave S.W.
Dental Department
Grand Rapids, MI 49503-4502

Phone

(616) 913-8401

Fax

(616) 742-1322

NPI assigned

Feb 14, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1202947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1801064654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CLINICA SANTA MARIA 730 GRANDVILLE AVE S.W.",
            "address_2": "DENTAL DEPARTMENT",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-913-8401",
            "fax_number": "616-742-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLINICA SANTA MARIA 730 GRANDVILLE AVE S.W.",
            "address_2": "DENTAL DEPARTMENT",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034502",
            "telephone_number": "616-913-8401",
            "fax_number": "616-742-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRANYAN",
        "first_name": "CARL",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-14",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901008455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124461490",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Branham
• Aubrey Michele Brannick, FNP-BC
• Alexis Branshaw
• Madison Marie Branson
• Shylah Brantley
• Dakota Brasseur
• Connor Brassington, LPC
• Megan Elizabeth Bratcher, PH.D
• Felix Bratosin, MD, PHD
• Lisa Williams Bratsburg, LMSW

• General Practice Dentistry in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.