Individual provider Active NPI

Brian B. Novy, DDS

  • Dentist
  • Newhall, CA
National Provider Identifier
1831221688
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
54739 Issued in CA
Practice address
22800 Lyons Ave
Suite 200
Newhall, CA 91321-6800
Phone
(661) 254-1884
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 54739 CA Primary

Addresses

Primary practice location

22800 Lyons Ave
Suite 200
Newhall, CA 91321-6800

Mailing address

1965 Coulston St
Unit #19
Loma Linda, CA 92354-1740
Phone (805) 573-3751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20240403001159 MA Order and Referring Only - DentistPractitioner - Dentist 4385082882

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
54739CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
David a Tanner DDS Inc Past Accepting new patients
S Kutlay DDS Corp PastSince Aug 8, 2018 Accepting new patients

Organizations & group practices 2

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831221688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1965 COULSTON ST",
            "address_2": "UNIT #19",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923541740",
            "telephone_number": "805-573-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22800 LYONS AVE",
            "address_2": "SUITE 200",
            "city": "NEWHALL",
            "state": "CA",
            "postal_code": "913216800",
            "telephone_number": "661-254-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOVY",
        "first_name": "BRIAN",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "54739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newhall, CA

Sources for this page

Verify at the official NPI Registry.