Bradford L Picot, DDS, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8158 Issued in NC

Legal business name

BRADFORD L PICOT, DDS, P.A.

Doing business as

Southend Dentistry

Practice address

1520 South Blvd
Suite 110
Charlotte, NC 28203-4786

Phone

(704) 335-8266

Fax

(704) 335-8267

NPI assigned

Aug 13, 2009

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bradford Lee Picot, DDS

Title

Owner/Dentist

Phone

(704) 335-8266

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Southend Dentistry Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1250121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250121600000",
    "number": "1003048752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 SOUTH BLVD",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034786",
            "telephone_number": "704-335-8266",
            "fax_number": "704-335-8267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 SOUTH BLVD",
            "address_2": "SUITE 110",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282034786",
            "telephone_number": "704-335-8266",
            "fax_number": "704-335-8267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD L PICOT, DDS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-13",
        "last_updated": "2009-08-13",
        "status": "A",
        "authorized_official_last_name": "PICOT",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "704-335-8266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8158",
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "NC",
            "license": "8158",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5908420",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southend Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Brackett, LMBT, NCTMB
• Katherine M Brackin, BT
• Caroline Bracksieck, MS, CCC/SLP
• Douglas Wayne Bradberry, D.C.
• William Timothy Brader, MD
• Bradford OB/GYN
• Grace Bradford
• Jesse Campbell Bradford, D.D.S.
• Bradley a Wruble OD PLLC
• Bradley-Reid Corporation

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.