Individual provider Active NPI

Brian Nelson, D.M.D.

  • General Practice Dentistry
  • Chandler, AZ
National Provider Identifier
1811204068
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8018 Issued in AZ
Practice address
3190 S Gilbert Rd Ste 1
Chandler, AZ 85286-5106
Phone
(602) 620-6812
NPI assigned
Sep 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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 8018 AZ Primary

Addresses

Primary practice location

3190 S Gilbert Rd Ste 1
Chandler, AZ 85286-5106

Mailing address

3190 S Gilbert Rd Ste 1
Chandler, AZ 85286-5106

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
I20150806011936 AZ Order and Referring Only - DentistPractitioner - Dentist 8325352172

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dentistry by the Nelsons, PLLC CurrentSince Jun 11, 2023 Accepting new patients

Locations

3190 S Gilbert Rd
Ste 1
Chandler, AZ 85286
Phone (209) 481-2544

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.

NPI Registry JSON

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

{
    "created_epoch": "1283990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1811204068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3190 S GILBERT RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852865106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 S GILBERT RD STE 1",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852865106",
            "telephone_number": "602-620-6812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-09",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.