Active NPI
Bradley L Phillips, D.M.D.
- Periodontics
- Forest Hill, MD
National Provider Identifier
1053434498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 8121
- Practice address
- 2018 Rock Spring Rd
Forest Hill, MD 21050-2631 - Phone
- (410) 879-4444
- Fax
- (410) 893-0112
- NPI assigned
- Apr 9, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 8121 | MD | Primary |
Addresses
Primary practice location
2018 Rock Spring Rd
Forest Hill, MD 21050-2631
Mailing address
15927 York Rd
Sparks, MD 21152-9343
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8121 | MD | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bel Air Dental Health Associates | Periodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Smile Partners of Bel Air
- Dentist
- Forest Hill, MD
- NPI 1407003684
Periodontics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176076800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053434498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15927 YORK RD",
"city": "SPARKS",
"state": "MD",
"postal_code": "211529343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2018 ROCK SPRING RD",
"city": "FOREST HILL",
"state": "MD",
"postal_code": "210502631",
"telephone_number": "410-879-4444",
"fax_number": "410-893-0112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "BRADLEY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "8121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hill, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.