Jonathan Pierce Brennan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14971 Issued in MN

Practice address

1515 Saint Francis Ave Ste 145
Shakopee, MN 55379-4307

Phone

(952) 496-1538

NPI assigned

Jul 11, 2023

Last updated

Jul 11, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PDG, P.a.

  dba Park Dental

  • General Practice Dentistry
  • Shakopee, MN
  • NPI 1891853206
  NPD (past)
• PDG, PA

  • Dental Clinic/Center
  • Savage, MN
  • NPI 1598128647
  NPD (past)

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1962180646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 W LAKE ST UNIT 734",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554162183",
            "telephone_number": "630-464-0296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SAINT FRANCIS AVE STE 145",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553794307",
            "telephone_number": "952-496-1538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14170 Hwy 13 S",
            "address_purpose": "LOCATION",
            "city": "Savage",
            "state": "MN",
            "postal_code": "553782192",
            "country_code": "US",
            "telephone_number": "952-444-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "JONATHAN",
        "middle_name": "PIERCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-11",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marquitta Crystal Braih, APRN
• Harley Jean Brake Walker
• Jamie Brandell
• Hilary Breedon, NP
• Teresa L Brenke
• Bridge Chiropractic
• Bridge Chiropractic & Wellness
• Bridge Languages LLC
• Anna Lea Bromeland, OTR/L
• Sasha Kohana-Yamada Broniola

• General Practice Dentistry in Shakopee, MN
• Providers in Shakopee, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.