Jae Brimhall, DMD, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

34865 Issued in TX

Practice address

3123 Green Meadow Dr
San Angelo, TX 76904-6977

Phone

(325) 208-4654

NPI assigned

Oct 3, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1831473305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 AVALON LN",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750197579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3123 GREEN MEADOW DR",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769046977",
            "telephone_number": "325-208-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIMHALL",
        "first_name": "JAE",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-10-03",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "9033",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "DEN00202177",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "34865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirk Brewer, MD
• Myalisha Briels, BCBA
• Jeffrey Briggs, D.O.
• Joe Glen Briley, ATC, LAT
• Michelle Briley, RN
• Anna Brinkman, M.S., CCC-SLP
• Erin Renae Bristo, M.S., CFY-SLP
• Levi Cole Britting, PT, DPT
• Kristy Brody, CCC-SLP
• Billy Berneard Brooks, L.C.D.C.

• Orthodontics and Dentofacial Orthopedics Dentistry in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.