Mark Bradle, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS040480 Issued in PA

Practice address

625 S Duke St
Lancaster, PA 17602-4509

Phone

(717) 299-6371

NPI assigned

Jun 23, 2015

Last updated

Jun 23, 2015By the provider in NPPES

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 LA

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

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

{
    "created_epoch": "1435017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435017600000",
    "number": "1225410590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9306 VANGUARD CT",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211178291",
            "telephone_number": "912-414-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 S DUKE ST",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176024509",
            "telephone_number": "717-299-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLE",
        "first_name": "MARK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-23",
        "last_updated": "2015-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS040480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Claudette Boyer
• Richard G Boyer
• Angela A Braas, SLP
• Lori Nicole Brackbill, PA-C
• William Charles Bradford, D.O.
• Stanley Bradley, PHARM. D
• Thomas George Bradley Jr., R. PH.
• Rushil Brahmbhatt
• Kaitlin Brakeall, LSW
• James L Bramble, D.D.S.

• General Practice Dentistry in Lancaster, PA
• Providers in Lancaster, PA by specialty
• General Practice Dentistry in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.