Rebekah R Brevard, DMD

Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Cape May Court House, NJ

NPI 1982607891 · NPPES record last updated Nov 19, 2012

Key facts

NPI
1982607891
Entity type
Individual (NPI type 1)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
DI022121 (NJ)
Practice address
101 Stone Harbor Blvd
Cape May Court House, NJ 08210-2135
Phone
(609) 465-3111
Fax
(609) 465-5064
NPI assigned
May 24, 2005
Sex
Female
Sole proprietor
No

Organizations & group practices 2

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.

Medicare Care Compare profile

Specialty
Oral Surgery
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1035 N Black Horse Pike
Williamstown, NJ 08094-2840
Phone (856) 740-1300

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20051026000020 NJ Practitioner - Oral Surgery
Practitioner - Maxillofacial Surgery
1759313521 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
DI022121NJMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Care Oral Surgery LLC Current
since Jun 1, 2016
Accepting new patients
South Jersey Center for Oral & Maxillofacial Surgery, LLC Oral and Maxillofacial Surgery Past Accepting new patients

Locations

1035 N Black Horse Pike
Ste 7
Williamstown, NJ 08094
Phone (856) 740-1300

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DI022121 NJ Yes

Addresses

Primary practice location

101 Stone Harbor Blvd
Cape May Court House, NJ 08210-2135

Mailing address

PO Box 898
Cape May Court House, NJ 08210-0898
Phone (609) 465-4340

Other providers in Cape May Court House, NJ

All providers in Cape May Court House, NJ · Oral and Maxillofacial Surgery (Dentist) in New Jersey

Sources for this page

Verify at the official NPI Registry.