Nicholas Branham, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

2024009328 Issued in MO

Practice address

1 Barnes Jewish Hospital PLZ Ste 230
Saint Louis, MO 63110-1003

Phone

(314) 361-6006

NPI assigned

Feb 24, 2020

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

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Maxillofacial SurgeryAlso: Oral Surgery

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Greater St Louis Oral and Maxillofacial Surgery PCGroup PAC ID 4981893823, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Greater St Louis Oral & Maxillofacial Surgery PC

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Louis, MO
  • NPI 1518158989
  Medicare reassignment Care Compare group NPD
• Allen Sclaroff DDS Inc

  • Oral and Maxillofacial Surgery (Dentist)
  • Saint Louis, MO
  • NPI 1114190220
  NPD
• South County Dental Imaging Center

  • Radiology Clinic/Center
  • Saint Louis, MO
  • NPI 1053647008
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation

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

{
    "created_epoch": "1582502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1972137479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD STE 1010",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171210",
            "telephone_number": "314-721-1010",
            "fax_number": "314-721-5276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNES JEWISH HOSPITAL PLZ STE 230",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101003",
            "telephone_number": "314-361-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12818 Tesson Ferry Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631282945",
            "country_code": "US",
            "telephone_number": "314-842-0020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1034 S Brentwood Blvd Ste 1010",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631171210",
            "country_code": "US",
            "telephone_number": "314-721-1010",
            "fax_number": "314-721-5276",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRANHAM",
        "first_name": "NICHOLAS",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-24",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2024009328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Eric Brandt, MD
• Whitney Stina Brandt, MD
• Tracy Brangle, MS, CCC-SLP
• Daphne Wang Branham, MD
• Meghann Elizabeth Branham, AGNP
• Sean Kelly Branham, D.C.
• Nikoleta Brankov, MD
• Lindsey Branson
• Melissa Branson
• Sean Allen Brant, PA-C

• Oral and Maxillofacial Surgery (Dentist) in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.