Provider Demographics
NPI:1659473676
Name:BROSNIHAN, JAMES BRIAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:BRIAN
Last Name:BROSNIHAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 NORTH OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68045
Mailing Address - Country:US
Mailing Address - Phone:402-685-5677
Mailing Address - Fax:402-685-6863
Practice Address - Street 1:228 NORTH OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NE
Practice Address - Zip Code:68045
Practice Address - Country:US
Practice Address - Phone:402-685-5677
Practice Address - Fax:402-685-5677
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE49751223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47063818600Medicaid
04730OtherBCBS