Individual provider Active NPI

Jonathan Jay Brennan, MD, DMD, MPH

  • General Practice Dentistry
  • Chandler, AZ
National Provider Identifier
1891057030
Registry record updated May 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D008485 Issued in AZ
Practice address
1929 E. Ray Rd.
Ste 2
Chandler, AZ 85225
Phone
(480) 498-8825
Fax
(480) 498-8826
NPI assigned
Jun 13, 2012
Last updated
May 24, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D008485 AZ Primary

Addresses

Primary practice location

1929 E. Ray Rd.
Ste 2
Chandler, AZ 85225

Mailing address

1929 E. Ray Rd.
Ste 2
Chandler, AZ 85225
Phone (480) 498-8825

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D008485AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1339545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464048000000",
    "number": "1891057030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 E. RAY RD.",
            "address_2": "STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85225",
            "telephone_number": "480-498-8825",
            "fax_number": "480-498-8826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 E. RAY RD.",
            "address_2": "STE 2",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "85225",
            "telephone_number": "480-498-8825",
            "fax_number": "480-498-8826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "JONATHAN",
        "middle_name": "JAY",
        "credential": "MD, DMD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-13",
        "last_updated": "2016-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D008485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2016; 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.