Individual provider Active NPI

Brandy Malia Dale

  • General Practice Dentistry
  • Littleton, CO
National Provider Identifier
1861784159
Registry record updated Jul 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10494 Issued in CO
Practice address
26 W Dry Creek Cir Ste 430
Littleton, CO 80120-4475
Phone
(720) 438-9017
NPI assigned
May 5, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 10494 CO Primary

Addresses

Primary practice location

26 W Dry Creek Cir Ste 430
Littleton, CO 80120-4475

Mailing address

7022 S Lamar St
Littleton, CO 80128-3914
Phone (720) 438-9017

Other practice location 1

1050 W Perimeter Rd. Ste B5-19
779 MDG
Andrews AFB, MD 20762
Phone (720) 438-9017

Other names 1

  • Brandy Dale Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20230306001480 CO Order and Referring Only - DentistPractitioner - Dentist 6800269275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10494COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brandy M Dale DDS PLLC General Practice CurrentSince Oct 16, 2022 Accepting new patients

Locations

26 W Dry Creek Cir
Ste 430
Littleton, CO 80120
Phone (303) 794-6959

Organizations & group practices 1

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": "1304553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658793600000",
    "number": "1861784159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7022 S LAMAR ST",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801283914",
            "telephone_number": "720-438-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W DRY CREEK CIR STE 430",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801204475",
            "telephone_number": "720-438-9017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1050 W Perimeter Rd. Ste B5-19",
            "address_2": "779 MDG",
            "address_purpose": "LOCATION",
            "city": "Andrews AFB",
            "state": "MD",
            "postal_code": "20762",
            "country_code": "US",
            "telephone_number": "720-438-9017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DALE",
        "first_name": "BRANDY",
        "middle_name": "MALIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-05",
        "last_updated": "2022-07-26",
        "certification_date": "2022-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "10494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "DALE",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.