Colin Russell Brady, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1856639 Issued in MA

Practice address

8 Cedar St Ste 65
Woburn, MA 01801-6362

Phone

(781) 937-3050

NPI assigned

May 14, 2013

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

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mark Pernokas, DMD

  • Dentist
  • Woburn, MA
  • NPI 1174985667
  NPD (past)

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

{
    "created_epoch": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1154767374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 CEDAR ST STE 65",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016362",
            "telephone_number": "781-937-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CEDAR ST STE 65",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016362",
            "telephone_number": "781-937-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "COLIN",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1856639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Boyages, BS, MA
• Mary Boyle, PT
• Maureen A. Boyle, MBA, R.D.
• Julia Brachanow, LADC1
• Jacob F Bradley, OT
• Julie Brady, MED
• Alicia Braga, DPT
• Carolyn Marquardt Braga, DVM
• Katherine Susan Bragdon, PT, DPT
• Carolina Brandao

• General Practice Dentistry in Woburn, MA
• Providers in Woburn, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.