DR. BROOK A DERENZY (D.D.S.) – General Practice Dentistry, NPI 1831125426
General Practice Dentistry
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
19 DENTIST in OR
Provider Addresses for DR. BROOK A DERENZY (D.D.S.)
1553 NW Canal Blvd
Suite A
Redmond, OR 977561341
Phone: (541) 923-2880
Fax: (541) 923-2881
Type: Location
8 WESTWOODS DR
LIBERTY, MO 640683519
Phone: (816) 753-3737
Fax: (816) 781-7895
Type: Mailing
Northwest Canal Boulevard, Redmond, Deschutes County, Oregon, 91156, United States
SUITE A
REDMOND, OR 977561341
Phone: (541) 923-2880
Fax: (541) 923-2881
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $415.
Total Amount is formed as General ($415) + Research ($0) + Ownership ($0) = $415.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Dentsply Sirona Inc ($294).
Total Amount
$415
General + Research + Ownership
Payments
11
Total payment records
General Amount
$415
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Dentsply Sirona Inc | $294 |
| Straumann USA LLC | $99 |
| Henry Schein, Inc. | $23 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-03
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250603000622 | I | Dentist | MO | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 97756)
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