Victor P Bradford, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8234 Issued in CO

Practice address

2828 International Cir
Colorado Springs, CO 80910-3127

Phone

(719) 475-0783

Fax

(719) 475-7478

NPI assigned

Mar 19, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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.

• Peak Vista Community Health Centers

  • Federally Qualified Health Center (FQHC)
  • Colorado Springs, CO
  • NPI 1124321880
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245354745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 PRINTERS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103190",
            "telephone_number": "719-228-6635",
            "fax_number": "719-228-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 INTERNATIONAL CIR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103127",
            "telephone_number": "719-475-0783",
            "fax_number": "719-475-7478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "VICTOR",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "8234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29930812",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia L Braden, PHD
• Nancy Bradfield
• Brant Alan Bradford, DDS
• Katherine Ellen Bradford, RN
• Taylor Bradford
• Jessica Bradigan, NP
• Bradley W. Smith, D.O., PLLC
• Kathryn Bradley-Beeler
• Blake Morgan Bradley, LPCC
• Bobbie Leanna Bradley, AG-ACNP

• General Practice Dentistry in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.