Alijah Bradley, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 20845 Issued in FL

Practice address

4267 W Commercial Blvd
Tamarac, FL 33319-3305

Phone

(954) 677-3202

Fax

(954) 677-3201

NPI assigned

Jul 31, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• FL HMO C-SNP
• FL HMO D-SNP
• devoted network organization-84bf27aa-506a-49c4-8818-702cf5e8efb3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Allure Dental PLLC

  • Dentist
  • Tamarac, FL
  • NPI 1649784166
  NPD (past)
• Marco Dental Care, PA

  • Dentist
  • Marco Island, FL
  • NPI 1053656264
  NPD (past)
• Sleeptreatmentdirectinc

  • General Practice Dentistry
  • Bonita Springs, FL
  • NPI 1801418421
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1003224148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19255 NE 10TH AVE APT 225",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331795936",
            "telephone_number": "734-904-4589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4267 W COMMERCIAL BLVD",
            "city": "TAMARAC",
            "state": "FL",
            "postal_code": "333193305",
            "telephone_number": "954-677-3202",
            "fax_number": "954-677-3201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "ALIJAH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-31",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 20845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Bossert
• Fafasoraya Bouadjadja
• Jacqueline D Boutrouille, M.D., P.A.
• Maria Boutsikos, DMD
• David Mark Bower, MD
• Ted Hugh Brady, D.O.
• Joan Braide
• Carolee Brailsford
• Jennifer C Branchcomb, ATC
• Pamela Jean Brannen, PT,MS

• General Practice Dentistry in Tamarac, FL
• Providers in Tamarac, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.