Active NPI
Bradner J Lawrence, DDS
- General Practice Dentistry
- Marana, AZ
National Provider Identifier
1194924969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D4597
- Practice address
- 12610 West Silverbell Rd
Marana, AZ 85653 - Phone
- (520) 616-4562
- Fax
- (510) 682-3548
- NPI assigned
- Jul 12, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D4597 | AZ | Primary |
Addresses
Primary practice location
12610 West Silverbell Rd
Marana, AZ 85653
Mailing address
12325 E Sutter Mill St
Tucson, AZ 85749
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D4597 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184198400000",
"number": "1194924969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12325 E SUTTER MILL ST",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85749"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12610 WEST SILVERBELL RD",
"city": "MARANA",
"state": "AZ",
"postal_code": "85653",
"telephone_number": "520-616-4562",
"fax_number": "510-682-3548"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAWRENCE",
"first_name": "BRADNER",
"middle_name": "J",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-12",
"last_updated": "2007-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D4597",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marana, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.