Richard Benjamin Bradley Jr., DDS
Individual provider Active NPI General Practice Dentistry · Halifax, VA
NPI 1154546869 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1154546869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 0401005683 (VA)
- Practice address
- 187 South Main St
Halifax, VA 24558 - Phone
- (434) 476-7885
- NPI assigned
- Apr 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401005683 | VA | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401005683 | VA | Yes |
Addresses
Primary practice location
187 South Main St
Halifax, VA 24558
Mailing address
187 South Main Street
Halifax, VA 24558
Phone (434) 476-7885
Other providers in Halifax, VA
- Erica Ballou
- Beginning Today Youth Services, LLC
- Earl Thomas Cage I
- Carlisa Antoinette Chandler
- Charles H Parker Jr MD PC
- Tyronza Coleman
- Commonwealth of Virginia State Board of Health
All providers in Halifax, VA · General Practice Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.