Braden Dental Group

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS031086L Issued in PA

Legal business name

BRADEN DENTAL GROUP

Practice address

214 State Rd
Media, PA 19063-1319

Phone

(610) 566-5322

NPI assigned

May 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Douglas Braden Sherly, DMD

Title

President

Phone

(609) 560-5902

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1180310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134330343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 STATE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 STATE RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190631319",
            "telephone_number": "610-566-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADEN DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHERLY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "BRADEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-560-5902",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS031086L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth J Boyd, M.D.
• Laura Ann Boyer, LCSW
• Donna J Boyle, OTR
• Mitchell Riley Boyle
• Trina L Bradburd, D. O.
• Norman Braslow, MD
• Julia Marie Breen-Kinsley, CCC-SLP
• Jonathan Breen
• Jennifer Breslin, PSY.D.
• Brian Crispell D.P.M

• General Practice Dentistry in Media, PA
• Providers in Media, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.