Bradley Matthew Farrow, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN012381 Issued in GA

Practice address

4720 Traders Way
Suite 300
Thompsons Station, TN 37179-5366

Phone

(615) 595-1559

Fax

(615) 595-9945

NPI assigned

Nov 30, 2006

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 identifiers 5

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 and National Provider Directory roles.

• Bradley Farrow DMD PC

  • Pediatric Dentistry
  • Thompsons Station, TN
  • NPI 1144542051
  NPD (past) Authorized official

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271289600000",
    "number": "1124195250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4720 TRADERS WAY",
            "address_2": "SUITE 300",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371795366",
            "telephone_number": "615-595-1559",
            "fax_number": "615-595-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 TRADERS WAY",
            "address_2": "SUITE 300",
            "city": "THOMPSONS STATION",
            "state": "TN",
            "postal_code": "371795366",
            "telephone_number": "615-595-1559",
            "fax_number": "615-595-9945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARROW",
        "first_name": "BRADLEY",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2010-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN012381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS MEDICAID",
            "identifier": "100916",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1516786",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL MEDICAID",
            "identifier": "9183408",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE",
            "identifier": "1516786",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "605327619A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacy Leigh Donaldson
• Dr. Sarah Humphreys PLLC
• Lauren Marshall Dutton, PA
• Edward Kenan Enoch, M.S., CCC-SLP
• Alison Patricia Eschrich, M.A.
• Fast Pace Medical Clinic PLLC
• Shelby Fathauer, FNP-C APRN
• Tricia Camille Faulkner, PHARM D
• Brandi Cirotto Felts, LCSW
• Ashlee Ferrara

• Pediatric Dentistry in Thompsons Station, TN
• Providers in Thompsons Station, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.