Brandon Breard, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

4647 Issued in AR

Practice address

45 W Colt Square Dr
Fayetteville, AR 72703-2814

Phone

(318) 547-9507

NPI assigned

Aug 6, 2020

Last updated

Nov 11, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1596672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1831709633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W COLT SQUARE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032814",
            "telephone_number": "479-521-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W COLT SQUARE DR",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727032814",
            "telephone_number": "318-547-9507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREARD",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-06",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "ETN793",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AR",
            "license": "4647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Lynn Brawner, AGACNP-BC
• Jeremy Ryan Braziel, ATC
• Spencer Brazil
• Eric R Bready, MD
• Anna Stilinovic Breard, PA-C
• Breast Treatment Associates, P.a.
• Jennifer Breathitt, APRN
• Kyndel Hope Brecheisen, APN
• Raymond Curtis Bredfeldt, MD
• Heidi Richter Brekelbaum, LAC

• Periodontics in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Periodontics in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.

Verify at the official NPI Registry.