NPI 1689165425
1+ Years Experience Individual
DR. BRIAN GEORGE MCGUIRE DMD
05/29/2018
PROVIDER ENUMERATION DATE
07.12.2018
LAST UPDATE DATE
1689165425
NPI NUMBER
About DR. BRIAN GEORGE MCGUIRE
Sole proprietor? No, Entity Type 1 Provider (Individual) is not a Sole Proprietor.
DR. BRIAN GEORGE MCGUIRE is a provider established in BRIGHTON, MA. The NPI number of DR. BRIAN GEORGE MCGUIRE is 1689165425 and was assigned on 05/29/2018. The practitioners primary taxonomy code is: 390200000X .
Mailing address
- City: BRIGHTON
- State: MA
- Postal code: 21355427
- Phone: 3092357257
- Address: 24 SIDLAW RD
Primary Practice Address
- Region : BRIGHTON, MA
- NPI : 1689165425
- Phone : 3092357257
- Postalcode : 2135
- Address : 24 SIDLAW RD
Provider taxonomy - Student in an Organized Health Care Education/Training Program
- Taxonomy code: 390200000X
The taxonomy is not the primary taxonomy.
Taxonomy description: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Healthcare provider taxonomy #2 - Dentist
- Taxonomy code: 1223G0001X
- License number: DN1857992
- License state: MA
The taxonomy is the primary taxonomy (there can be only one per NPI record).
Taxonomy description: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients" oral health needs.
Reference NPI Information. Full replica of the CMS (NPPES) NPI record
| Field Name | Value |
|---|---|
| Provider First Line Business Practice Location Address | 24 SIDLAW RD |
| The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. | |
| Provider Business Practice Location Address City Name | BRIGHTON |
| The city name in the location address of the provider being identified. | |
| Provider Business Practice Location Address State Name | MA |
| The State or Province name in the location address of the provider being identified. | |
| Provider Business Practice Location Address Postal Code | 2135 |
| The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. | |
| Provider Business Practice Location Address Telephone Number | 3092357257 |
| The telephone number associated with the location address of the provider being identified. | |
| NPI | 1689165425 |
| 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. | |
| Healthcare Provider Taxonomy 1 | 390200000X |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. | |
| Provider Enumeration Date | 05/29/2018 |
| The date the provider was assigned a unique identifier (assigned an NPI). | |
| Last Updated | 07.12.2018 |
| The date that a record was last updated or changed. | |
| Entity Type | Individual |
Code describing the type of health care provider that is being assigned an NPI. Codes are:
| |
| Provider Organization Name (Legal Business Name) | DR. BRIAN GEORGE MCGUIRE |
| Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. | |
| Provider First Line Business Mailing Address | 24 SIDLAW RD |
| The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address". | |
| Provider Business Mailing Address City Name | BRIGHTON |
| The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name". | |
| Provider Business Mailing Address State Name | MA |
| The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name". | |
| Provider Business Mailing Address Postal Code | 21355427 |
| The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code". | |
| Provider Business Mailing Address Telephone Number | 3092357257 |
| The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number". | |
| Healthcare Provider Taxonomy Code #1 | 390200000X |
| The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization. | |
| Healthcare Provider Taxonomy 1 | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. | |
| Healthcare Provider Primary Taxonomy Switch 1 | N |
Primary Taxonomy:
| |
| Healthcare Provider Taxonomy Code 2 | 1223G0001X |
| Healthcare Provider Taxonomy 2 | Dentist |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients" oral health needs. | |
| Provider License Number 2 | DN1857992 |
| Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section. | |
| Provider License Number State Code 2 | MA |
| Healthcare Provider Primary Taxonomy Switch 2 | Y |
Primary Taxonomy:
| |
| Provider Gender Code | M |
| |
| Is sole proprietor | N |
|