Organization Active NPI

Brace Busters LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Philadelphia, PA
National Provider Identifier
1902208739
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
BRACE BUSTERS LLC
Practice address
211 Geiger Rd
Suite B
Philadelphia, PA 19115-1009
Phone
(215) 677-0380
Fax
(215) 969-0215
NPI assigned
Sep 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Authorized official

Name
Dr. Jason Bresler, DMD
Title
Owner
Phone
(215) 677-0380

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

211 Geiger Rd
Suite B
Philadelphia, PA 19115-1009

Mailing address

211 Geiger Rd
Suite B
Philadelphia, PA 19115-1009
Phone (215) 677-0380

Other identifiers 1

IdentifierTypeStateIssuer
1029645820001MedicaidPA

National Provider Directory

National Provider Directory

Locations

211 Geiger Rd
Ste B
Philadelphia, PA 19115
Phone (215) 677-0380

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1411516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1902208739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 GEIGER RD",
            "address_2": "SUITE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151009",
            "telephone_number": "215-677-0380",
            "fax_number": "215-969-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 GEIGER RD",
            "address_2": "SUITE B",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191151009",
            "telephone_number": "215-677-0380",
            "fax_number": "215-969-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRACE BUSTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-24",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "BRESLER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-677-0380",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1029645820001",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.