Brodhead Dental Center

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS022287-L Issued in PA

Legal business name

BRODHEAD DENTAL CENTER

Practice address

3544 Brodhead Rd
Monaca, PA 15061

Phone

(724) 728-1212

Fax

(724) 728-4339

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard Joseph Gradisek, D.D.S.NPI 1396825469

Title

Owner

Phone

(724) 728-1212

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richard Joseph Gradisek, D.D.S.

  • General Practice Dentistry
  • Monaca, PA
  • NPI 1396825469

  General Practice

  NPD (past) Authorized official
• Brandon Michael Lackovich, DDS

  • Dentist
  • Monaca, PA
  • NPI 1720724230

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154526374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3544 BRODHEAD RD",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "150613126",
            "telephone_number": "724-728-1212",
            "fax_number": "724-728-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3544 BRODHEAD RD",
            "city": "MONACA",
            "state": "PA",
            "postal_code": "15061",
            "telephone_number": "724-728-1212",
            "fax_number": "724-728-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRODHEAD DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRADISEK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "724-728-1212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS022287-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Ann Boyde, LMT
• Brandon M. Lackovich DDS PLLC
• Boerre Henrik Brevik, PT
• Brief Therapeutic Solutions, Inc.
• Brighton Radiology
• Gregory Earl Brummitt, D.M.D.
• Carrie Elizabeth Buckwalter
• Richard A Budney Jr., PT
• Melissa Campbell, RDH, PHDHP
• Erica Caprini

• All providers in Monaca, PA
• 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.