Mary Angela Brafford, D.M.D., M.S.

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

0401411871 Issued in VA

Practice address

1 Pinckney Blvd
Beaufort, SC 29902-6122

Phone

(240) 277-9772

NPI assigned

Jan 25, 2006

Last updated

Jun 1, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Mary Angela Dietrich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275350400000",
    "number": "1053381681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94 FACTORY CREEK CT",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299071487",
            "telephone_number": "240-277-9772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PINCKNEY BLVD",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026122",
            "telephone_number": "240-277-9772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAFFORD",
        "first_name": "MARY",
        "middle_name": "ANGELA",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2010-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019-025050",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "VA",
            "license": "0401411871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "DIETRICH",
            "middle_name": "ANGELA",
            "prefix": "DR.",
            "credential": "D.M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Melissa Dawn Bowers, MD
• Seth Bowers
• Mariel Boyer, PA-C
• Jennifer Lynn Bradham, RN
• Cecile Irvine Bradshaw, PH.D.
• Branch Medical Clinic McAs Beaufort
• Branch Medical Clinic, Marine Recruit Depot, Parris Island, SC
• Mary Brazier
• Peggy Breard
• Lindsey Breaux

• Prosthodontics in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Prosthodontics in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.