Active NPI
Brian B. Novy, DDS
- Dentist
- Newhall, CA
National Provider Identifier
1831221688
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 54739
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240403001159 | MA | Order and Referring Only - Dentist | 4385082882 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54739 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David a Tanner DDS Inc | Past | Accepting new patients | |
| S Kutlay DDS Corp | Past | 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.
-
- General Practice Dentistry
- Newhall, CA
- NPI 1508234766
-
- Dental Clinic/Center
- Santa Clarita, CA
- NPI 1437630340
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.