Dr Bradley Brennecke, is a
Dentist - General Practice based in Goshen, Ohio. Dr Bradley Brennecke is licensed to practice in Ohio (license number 16397) and his current practice location is
6782 Goshen Rd, Goshen, Ohio. He can be reached at his office (for appointments etc.) via phone at
(513) 722-2933.
NPI number for Dr Bradley Brennecke is 1063593861 and his current mailing address is 6782 Goshen Rd, Goshen, Ohio. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1063593861.
Healthcare Provider's Profile
| Full Name | Dr Bradley Brennecke |
|---|
| Gender | Male |
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| Speciality | Dentist - General Practice |
|---|
| Location | 6782 Goshen Rd, Goshen, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1063593861
- Provider Enumeration Date: 10/18/2006
- Last Update Date: 07/09/2007
Medical Identifiers
Medical identifiers for Dr Bradley Brennecke such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063593861 | NPI | - | NPPES |
| 2294539 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 16397 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Bradley Brennecke is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Bradley Brennecke,
6782 Goshen Rd,
Goshen, OH 45122-9317
Ph: (513) 722-2933 | Dr Bradley Brennecke,
6782 Goshen Rd,
Goshen, OH 45122-9317
Ph: (513) 722-2933 |
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