Bradley W. Willis,

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

4554 Issued in AL

Legal business name

BRADLEY W. WILLIS,

Practice address

8161 Seaton PL Ste a
Montgomery, AL 36116-7205

Phone

(334) 260-2929

Fax

(334) 396-7874

NPI assigned

Jun 26, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Bradley W Willis, D.M.D.NPI 1689782781

Title

Owner

Phone

(334) 260-2929

Specialties & licenses 1

Addresses

Other names 1

• Willis Dental Care Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bradley W Willis, DMD

  • General Practice Dentistry
  • Montgomery, AL
  • NPI 1689782781
  NPD (past) Authorized official

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435276800000",
    "number": "1285016154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8161 SEATON PL STE A",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361167205",
            "telephone_number": "334-260-2929",
            "fax_number": "334-396-7874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8161 SEATON PL STE A",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361167205",
            "telephone_number": "334-260-2929",
            "fax_number": "334-396-7874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY W. WILLIS,",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-26",
        "last_updated": "2015-06-26",
        "status": "A",
        "authorized_official_last_name": "WILLIS",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "334-260-2929",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AL",
            "license": "4554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willis Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jaycie Cai Braden
• George M Bradford, D.M.D.
• Lauren Harris Bradford, PHARMD
• Michael B Bradford, OD
• Toddneisha Bradford
• Jodi Bradley
• Robert H. Bradley, M.D.
• Shillisha Bradley
• James Michael Bradwell, MD
• Calin G Braicu, MD

• Dental Clinic/Center in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Dental Clinic/Center in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; 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.