Bradley Wayne Coleman,D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

3663 Issued in AR

Legal business name

BRADLEY WAYNE COLEMAN,D.D.S.

Practice address

330 Highway 5 North
Suite #10
Mountain Home, AR 72653

Phone

(870) 424-4670

Fax

(870) 425-4674

NPI assigned

Jun 9, 2008

Organization subpart

No

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

Authorized official

Name

Bradley Wayne Coleman, D.D.S.

Title

President

Phone

(870) 424-4670

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472601600000",
    "number": "1184883654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 HIGHWAY 5 NORTH",
            "address_2": "SUITE #10",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "72653",
            "telephone_number": "870-424-4670",
            "fax_number": "870-425-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 HIGHWAY 5 NORTH",
            "address_2": "SUITE #10",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "72653",
            "telephone_number": "870-424-4670",
            "fax_number": "870-425-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY WAYNE COLEMAN,D.D.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-09",
        "last_updated": "2016-08-31",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "870-424-4670",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AR",
            "license": "3663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168221608",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelsey L Bowers
• April Bowgen
• David John Bowgen
• Briana Bowman
• Hope Boyd, LPN
• Lucas Bradley, MD
• Rebecca M Bradley
• Shanah Bradley
• Marcella Bobette Bramblett, APRN
• Garrett Branaman, PT, DPT

• Dentist in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; 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.