Bradley Stephen Rabal, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-17406 Issued in OH

Practice address

3609 Park East Dr
Suite # 514
Beachwood, OH 44122-4331

Phone

(216) 593-8000

Fax

(216) 593-0228

NPI assigned

Mar 12, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 OH

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": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245362227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 PARK EAST DR",
            "address_2": "SUITE # 514",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224331",
            "telephone_number": "216-593-8000",
            "fax_number": "216-593-0228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 PARK EAST DR",
            "address_2": "SUITE # 514",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441224331",
            "telephone_number": "216-593-8000",
            "fax_number": "216-593-0228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABAL",
        "first_name": "BRADLEY",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-17406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ala N Qahwash, DPT
• Emily M Quay, DNP, APRN FNP-C
• Michaela Lea Querry, PA-C
• Angela Quinn, APRN-CNP
• Iran Quinnie Jr.
• Melissa Rackus, WHNP
• Katie Radabaugh
• Ebne Rafi, PHARMD
• Amr Raghban
• Somayeh Rahmanypour

• General Practice Dentistry in Beachwood, OH
• Providers in Beachwood, OH by specialty
• General Practice Dentistry in Ohio

• 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.