Individual provider Active NPI

Brandon J Webb, D.D.S., M.S.D.

  • Endodontics
  • Fair Oaks, CA
National Provider Identifier
1972840296
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
62128 Issued in CA
Practice address
6600 Mercy CT Ste 200
Fair Oaks, CA 95628-3198
Phone
(916) 472-1562
NPI assigned
Jan 7, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 62128 CA Primary

Addresses

Primary practice location

6600 Mercy CT Ste 200
Fair Oaks, CA 95628-3198

Mailing address

1420 E Roseville Pkwy
Suite 140-370
Roseville, CA 95661-3078
Phone (916) 481-3636

Other practice location 1

2322 Butano Dr
Suite 212A
Sacramento, CA 95825-0629
Phone (916) 481-3636 ext. 101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20180614003113 CA Order and Referring Only - DentistPractitioner - Dentist 3779838776

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1972840296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 E ROSEVILLE PKWY",
            "address_2": "SUITE 140-370",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613078",
            "telephone_number": "916-481-3636",
            "fax_number": "916-481-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 MERCY CT STE 200",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283198",
            "telephone_number": "916-472-1562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2322 Butano Dr",
            "address_2": "Suite 212A",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958250629",
            "country_code": "US",
            "telephone_number": "916-481-3636 x101",
            "fax_number": "916-481-3637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEBB",
        "first_name": "BRANDON",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-07",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "62128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

Verify at the official NPI Registry.