Individual provider Active NPI

Brian Wearner, D.D.S.

  • General Practice Dentistry
  • Northglenn, CO
National Provider Identifier
1891826723
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7297 Issued in CO
Practice address
10465 Melody Dr
Suite 207
Northglenn, CO 80234-4119
Phone
(303) 452-8813
Fax
(303) 452-1237
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 7297 CO Primary

Addresses

Primary practice location

10465 Melody Dr
Suite 207
Northglenn, CO 80234-4119

Mailing address

10465 Melody Dr
Suite 207
Northglenn, CO 80234-4119
Phone (303) 452-8813

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
I20151116000994 CO Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9537479910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7297COMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891826723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10465 MELODY DR",
            "address_2": "SUITE 207",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344119",
            "telephone_number": "303-452-8813",
            "fax_number": "303-452-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10465 MELODY DR",
            "address_2": "SUITE 207",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802344119",
            "telephone_number": "303-452-8813",
            "fax_number": "303-452-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEARNER",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "7297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northglenn, CO

Sources for this page

Verify at the official NPI Registry.