Active NPI
Brad L. Cottle, DMD
- Dentist
- Mesa, AZ
National Provider Identifier
1154533016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D6088
- Practice address
- 2346 E Brown Rd
Mesa, AZ 85213 - Phone
- (480) 969-3069
- Fax
- (480) 969-3419
- NPI assigned
- May 4, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | D6088 | AZ | Primary |
Addresses
Primary practice location
2346 E Brown Rd
Mesa, AZ 85213
Mailing address
2346 E. Brown Road
Mesa, AZ 85213
Phone (480) 988-7025
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160329001707 | AZ | Order and Referring Only - Dentist | 4385941806 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D6088 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543536000000",
"number": "1154533016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2346 E. BROWN ROAD",
"city": "MESA",
"state": "AZ",
"postal_code": "85213",
"telephone_number": "480-988-7025",
"fax_number": "480-969-3419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2346 E BROWN RD",
"city": "MESA",
"state": "AZ",
"postal_code": "85213",
"telephone_number": "480-969-3069",
"fax_number": "480-969-3419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTLE",
"first_name": "BRAD",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2018-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D6088",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.