Bradley Smith, D.M.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

64085 Issued in CA

Practice address

50 S San Mateo Dr Ste 160
San Mateo, CA 94401-3859

Phone

(305) 778-0827

Fax

(650) 375-8130

NPI assigned

Oct 21, 2014

Last updated

Oct 21, 2014By the provider in NPPES

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

Other names 1

• Dr. Bradley Kuper-Smith Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Peninsula Pediatric Dental Practice

  • Pediatric Dentistry
  • San Mateo, CA
  • NPI 1639590003
  NPD (past)

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413849600000",
    "number": "1023412921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 SO SAN MATEO DR #160",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "94401",
            "telephone_number": "305-778-0827",
            "fax_number": "650-375-8130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 S SAN MATEO DR STE 160",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944013859",
            "telephone_number": "305-778-0827",
            "fax_number": "650-375-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-21",
        "last_updated": "2014-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "64085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRADLEY",
            "last_name": "KUPER-SMITH",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Smccd
• Jack Smerdel
• Leticia Smiell
• Smile Dental Center S Lei & Y Chiang Inc
• Andrea Smith
• Christina Mary Smith
• Gary James Smith, CADC II, ICADC
• Nicole Sandra Smith
• Simone Smith
• Vernell Angenette Smith, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2014; 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.