DR. JOHN BRANDEBURA JR. (NPI# 1629038708) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629038708 |
| Entity Type | Individual |
| Full Name | DR. JOHN BRANDEBURA JR. |
| Credential | D.M.D. |
| Practice Address |
2407 S Waldron Rd Fort Smith AR 72903-3736 |
| Practice Telephone | 4794841011 |
| Practice Fax Number | 4794841205 |
| Mailing Telephone | 4794841011 |
| Mailing Fax Number | 4794841205 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2009-04-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2226 | AR | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | MEDICARE - GROUP NUMBER | 5C081 | 01 |
| GROUP NPI | 1548288244 | 01 | |
| UNITED CONCORDIA (GRP) | 000861460 | 01 | |
| AR | 127321679 | 05 | |
| OK | 100026580A | 05 | |
| UNITED CONCORDIA (INDVL) | 000812852 | 01 |
| Street Address |
2407 S WALDRON RD |
| City | FORT SMITH |
| State | AR |
| Zip Code | 72903-3736 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629043690 | James Shelton Ellis | Dentist | 2407 S Waldron Rd, Fort Smith, AR 72903-3736 | 2006-02-22 |
| 1548288244 | River Valley Oral & Maxillofacial Surgery Plc | Dentist | 2407 S Waldron Rd, Fort Smith, AR 72903-3736 | 2006-07-18 |
| 1871553958 | James Arthur Remerscheid | Dentist | 2407 S Waldron Rd, Fort Smith, AR 72903-3736 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285280016 | Bhg L, LLC | Clinic/Center | 1501 Waldron Road, Ste 203, Fort Smith, AR 72903 | 2019-08-16 |
| 1457905903 | Heather Snyder | Optometrist | 1021 South Waldron Road, Fort Smith, AR 72903 | 2019-08-01 |
| 1083272223 | Pediatric Therapy Connections LLC | Clinic/Center | 7601 Westminister Pl, Fort Smith, AR 72903 | 2019-06-03 |
| 1073092821 | Baptist Health Services | Psychiatry & Neurology | 3808 Gary St Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1104305853 | Baptist Health Services | Family Medicine | 5428 Ellsworth Rd Ste A, Fort Smith, AR 72903 | 2018-08-13 |
| 1417436171 | Baptist Health Services | Pediatrics | 5428 Ellsworth Rd Ste B, Fort Smith, AR 72903 | 2018-08-13 |
| 1558840421 | Baptist Health Services | Family Medicine | 3808 Gary St Ste A, Fort Smith, AR 72903 | 2018-08-10 |
| 1316434707 | Md Weight Loss and Wellness, LLC | Dietitian, Registered | 3416 Old Greenwood Road, Fort Smith, AR 72903 | 2018-04-20 |
| 1942695572 | Donna K Morgan | Counselor | 2408 S. 51st Court Suite G, Fort Smith, AR 72903 | 2015-03-31 |
| 1346658242 | Shelby Mural Esry | Dentist | 3200 Rogers Ave. Suite 111, Fort Smith, AR 72903 | 2014-07-24 |
| Find all providers in zip 72903 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285826933 | Oral Surgery Center Inc | Dentist | 600 Lexington Avenue, Fort Smith, AR 72901-4737 | 2007-08-16 |
| 1629043690 | James Shelton Ellis | Dentist | 2407 S Waldron Rd, Fort Smith, AR 72903-3736 | 2006-02-22 |
| 1902353717 | Thomas A. Sarna, Dds Pllc | Dentist | 2420 S 51st Ct, Fort Smith, AR 72903-3669 | 2016-09-09 |
| 1407254584 | Bd Specialist, Pllc | Dentist | 8309 Phoenix Ave, Fort Smith, AR 72903-6141 | 2014-12-05 |
| 1720326945 | Arkansas Oral & Facial Surgery Center Fort Smith Pllc | Dentist | 8309 Phoenix Ave, Fort Smith, AR 72903-6141 | 2013-01-23 |
| 1750390118 | Fort Smith Oral & Maxillofacial Surgery Group Pa-curry and Butler | Dentist | 2713 S 74th St, Suite 201, Fort Smith, AR 72903-5170 | 2006-08-05 |
| 1831108273 | William E Curry | Dentist | 2713 S 74th St, Suite 201, Fort Smith, AR 72903-5170 | 2006-08-05 |
| 1306855754 | Monte L Butler | Dentist | 2713 S 74th St, Suite 201, Fort Smith, AR 72903-5170 | 2006-08-05 |
| 1548288244 | River Valley Oral & Maxillofacial Surgery Plc | Dentist | 2407 S Waldron Rd, Fort Smith, AR 72903-3736 | 2006-07-18 |
| 1871553958 | James Arthur Remerscheid | Dentist | 2407 S Waldron Rd, Fort Smith, AR 72903-3736 | 2006-03-24 |
| Find all providers in FORT SMITH | ||||
| City | FORT SMITH |
| Zip Code | 72903 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.