Brian K Morris, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

30-022181 Issued in OH

Practice address

190 Water St
Suite 2
Jackson, OH 45640-1384

Phone

(740) 286-0480

Fax

(740) 286-8968

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Practice roles

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.

• Southern Ohio Mini Dental Implant Center

  • Dental Clinic/Center
  • Jackson, OH
  • NPI 1417572595
  NPD Authorized official
• Holzer Dental Clinic Jackson LLC

  • General Practice Dentistry
  • Jackson, OH
  • NPI 1295783074
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1861544470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 WATER ST",
            "address_2": "SUITE 2",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401384",
            "telephone_number": "740-286-0480",
            "fax_number": "740-286-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 WATER ST",
            "address_2": "SUITE 2",
            "city": "JACKSON",
            "state": "OH",
            "postal_code": "456401384",
            "telephone_number": "740-286-0480",
            "fax_number": "740-286-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORRIS",
        "first_name": "BRIAN",
        "middle_name": "K",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-022181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2330007",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2569135",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bailee G Montgomery
• Christopher Michael Montgomery Sr.
• Kristen D Montgomery
• Tom Moore, PC
• Breanna Morgan, CNP
• Cheryl Lyn Morris
• Pamela Mourning, RN
• Bonnie Sue Mullins, L.P.N,
• Chastity Faye Mullins
• Paul Mullins, PT

• Dentist in Jackson, OH
• Providers in Jackson, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.