=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194420109
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRANDON COZE PARRONE DDS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/31/2023
-----------------------------------------------------
Last Update Date | 02/27/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 331 N CHERRY ST
-----------------------------------------------------
City | VALENTINE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69201-1892
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-376-3390
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 331 N CHERRY STREET
-----------------------------------------------------
City | VALENTINE
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 69201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-376-3390
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 8041
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------