Individual provider Active NPI

Brandon T Ortega, DDS

  • General Practice Dentistry
  • Kansas City, MO
National Provider Identifier
1851075428
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2023021010 Issued in MO
Practice address
2121 Summit St
Kansas City, MO 64108-2126
Phone
(816) 471-0900
NPI assigned
Jun 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 62132 KS
General Practice Dentistry 1223G0001X 2023021010 MO Primary

Addresses

Primary practice location

2121 Summit St
Kansas City, MO 64108-2126

Mailing address

2121 Summit St
Kansas City, MO 64108-2126
Phone (816) 983-5937

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20230705001761 MO Practitioner - Dentist 2668831967 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
62132KSMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Samuel U. Rodgers Health Center, Inc. CurrentSince Jun 20, 2023 Accepting new patients
Samuel U. Rodgers Health Center, Inc CurrentSince Jun 20, 2023 Accepting new patients

Locations

825 Euclid Ave
Kansas City, MO 64124
Phone (816) 889-4816

2121 Summit St
Kansas City, MO 64108
Phone (816) 471-0900

Interoperability endpoints

  • Direct secure messaging: brandon.ortega.p1@direct.rodgershealth.nextgenshare.com

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": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686700800000",
    "number": "1851075428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 SUMMIT ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082126",
            "telephone_number": "816-983-5937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 SUMMIT ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641082126",
            "telephone_number": "816-471-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ORTEGA",
        "first_name": "BRANDON",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-14",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KS",
            "license": "62132",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2023021010",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.