Bradley Eli la Office

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

BRADLEY ELI LA OFFICE

Practice address

18981 Ventura Blvd FL 2
Tarzana, CA 91356-3237

Phone

(844) 235-9881

Fax

(760) 436-5123

NPI assigned

May 24, 2023

Organization subpart

Yes

Parent organization

BRADLEY A. ELI DENTAL CORPORATIONAs reported in NPPES

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

Authorized official

Name

Dr. Bradley Allen Eli, DND

Title

Ceo

Phone

(844) 235-9881

Specialties & licenses 2

Addresses

Tax ID family

Bradley Eli la Office2 organizations share this tax ID, including this one

Part of

Bradley a Eli Dental Corp

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Bradley Eli la Office

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
  • NPI 1326730821
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Bradley a. Eli Dental Corporation

  • Orofacial Pain Dentistry
  • Vista, CA
  • NPI 1962533919
  NPPES parent name

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692835200000",
    "number": "1306538681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18981 VENTURA BLVD FL 2",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563237",
            "telephone_number": "844-235-9881",
            "fax_number": "760-436-5123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18981 VENTURA BLVD FL 2",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563237",
            "telephone_number": "844-235-9881",
            "fax_number": "760-436-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY ELI LA OFFICE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRADLEY A. ELI DENTAL CORPORATION",
        "enumeration_date": "2023-05-24",
        "last_updated": "2023-08-24",
        "certification_date": "2023-07-27",
        "status": "A",
        "authorized_official_last_name": "ELI",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "844-235-9881",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DND"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orofacial Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Bowen
• Genaro Boyerman
• Geymi Bozkurt, FNP-C
• Varaz Bozoghlanian, MD
• Dana Braden, BCBA
• Brandie L Bradwell
• Chanel Bral
• Brand Tarzana Surgical Institute Inc
• Shabnum Puri Brar, M.P.T.
• Jodie Brato, RD

• Oral and Maxillofacial Surgery (Dentist) in Tarzana, CA
• Providers in Tarzana, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2023; 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.