Bracken Robert Godfrey, DDS, MS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4479 Issued in NH

Practice address

8 Clark Way
Somersworth, NH 03878-4403

Phone

(603) 692-2045

NPI assigned

Jul 2, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618617600000",
    "number": "1164629283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "MIL",
            "address_1": "PSC 561 BOX 781",
            "city": "FPO",
            "state": "AP",
            "postal_code": "963100008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 CLARK WAY",
            "city": "SOMERSWORTH",
            "state": "NH",
            "postal_code": "038784403",
            "telephone_number": "603-692-2045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Psc 561 Box 781",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AP",
            "postal_code": "963100008",
            "country_code": "US",
            "telephone_number": "315-253-3331",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "GODFREY",
        "first_name": "BRACKEN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-07-02",
        "last_updated": "2021-04-17",
        "certification_date": "2021-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4082",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "4479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Somersworth, NH
• General Practice Dentistry in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2021; 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.