Bradley R Johnson, D.M.D., M.S.D.

Primary specialty

DentistTaxonomy code 122300000X

License

0401413320 Issued in VA

Practice address

7288 Mentor Ave
Mentor, OH 44060-7578

Phone

(440) 946-0088

Fax

(757) 314-7942

NPI assigned

Aug 25, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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 Johnson D.M.D., M.S.D., LLC

  • Dental Clinic/Center
  • Mentor, OH
  • NPI 1710573548
  NPD Authorized official
• HQ US Army Dental Activities

  • Dentist
  • Newport News, VA
  • NPI 1134504574
  NPD (past)

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

{
    "created_epoch": "1314230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1154601839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 STERNBERG AVE",
            "address_2": "HQ US ARMY DENTAL ACTIVITY",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236041526",
            "telephone_number": "757-314-7944",
            "fax_number": "757-314-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7288 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607578",
            "telephone_number": "440-946-0088",
            "fax_number": "757-314-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRADLEY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-25",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John P. Ferron, M.D. & Timothy J. Pritchard, M.D. Inc
• Tyiesha Johns
• Wendy Johns
• Alexis Johnson
• Autumn Johnson, QMHS
• Christopher Johnson
• Debra Johnson
• Earlene P. Johnson, LISW-S
• Heather Johnson, COTA
• Holly Lynn Johnson

• Dentist in Mentor, OH
• Providers in Mentor, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.