Kenneth Brochin, DDS is a medicare enrolled "Dentist - General Practice" provider in Ottawa Hills, Ohio. His current practice location is
4210 W Central Ave, Ottawa Hills, Ohio. You can reach out to his office (for appointments etc.) via phone at
(419) 535-1066.
Kenneth Brochin is licensed to practice in Ohio (license number 15261) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1568527802.
Healthcare Provider's Profile
| Full Name | Kenneth Brochin |
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| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 4210 W Central Ave, Ottawa Hills, Ohio |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1568527802
- Provider Enumeration Date: 12/27/2006
- Last Update Date: 06/11/2009
Medicare PECOS Information:
- PECOS PAC ID: 3779809074
- Enrollment ID: I20150304001214
Medical Identifiers
Medical identifiers for Kenneth Brochin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568527802 | NPI | - | NPPES |
| 0336023 | Medicaid | OH | |
| 34-1389351 | Other | OH | TAX ID # |
| 01895 | Other | OH | PARAMOUNT HEALTH CARE |
| 818060 | Other | OH | WORKERS COMP POLICY # |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 15261 (Ohio) | Primary |
| 1223G0001X | Dentist - General Practice | 042386 (New York) | Secondary |
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. Kenneth Brochin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth Brochin, DDS
4210 W Central Ave,
Ottawa Hills, OH 43606-2207
Ph: (419) 535-1066 | Kenneth Brochin, DDS
4210 W Central Ave,
Ottawa Hills, OH 43606-2207
Ph: (419) 535-1066 |
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