BREANNA LEE IRIZARRY DMD
NPI 1184366114
Dentist - Oral and Maxillofacial Surgery in Charlottesville, VA

Q: What is Breanna Irizarry's NPI number?

The NPI number for Breanna Irizarry is 1184366114. It was assigned to this individual provider in the NPPES registry on April 11, 2022.

Q: What is Breanna Irizarry's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Breanna Irizarry enrolled in Medicare?

No. Breanna Irizarry has opted out of Medicare through July 8, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Breanna Irizarry was last updated on June 26, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 11, 2022Opted out of Medicare · through Jul 8, 2028

244 HYDRAULIC RIDGE RD, CHARLOTTESVILLE, VA 22901(434) 973-3348 Get Directions Write a Review

NPPES record last updated: June 26, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Aug 5, 2022, Apr 11, 2022 (2 updates tracked since 2022).

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About Breanna Lee Irizarry Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BREANNA LEE IRIZARRY DMD (NPI 1184366114) is an individual oral and maxillofacial surgery provider in Charlottesville, Virginia, licensed in Virginia (0442000445) and active in the NPI registry since April 2022. She has opted out of Medicare through July 8, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1184366114

Entity TypeIndividualFemale

Primary Taxonomy1223S0112X

Provider Legal NameBREANNA LEE IRIZARRYCredential: DMD

Location Address244 HYDRAULIC RIDGE RDCharlottesville, VA 22901-8124

Mailing Address244 Hydraulic Ridge RdCharlottesville, VA 22901-8124 · (434) 973-3348

Phone(434) 973-3348

Sole ProprietorYes

Enumeration DateApril 11, 2022

Last NPPES UpdateJune 26, 20262 updates tracked since enumeration

NPPES CertifiedJune 26, 2026

✔ NPI 1184366114 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in VA · 0442000445

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

244 HYDRAULIC RIDGE RD, Charlottesville, VA 22901

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Breanna Lee Irizarry Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 8, 2026 through July 8, 2028.

Opt-Out Effective DateJuly 8, 2026

Opt-Out In Effect ThroughJuly 8, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH ELIZABETH SNOW SUMMERS DMD, MD

Oral & Maxillofacial Surgery