Jonathan Paul Bradshaw, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8701 Issued in TN

Practice address

11121 Kingston Pike Ste C
Farragut, TN 37934-2890

Phone

(865) 986-5310

Fax

(865) 986-5319

NPI assigned

May 20, 2008

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Heritage Family Dentistry LLC

  • Dentist
  • Farragut, TN
  • NPI 1588055438
  NPD Authorized official

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1356508147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11121 KINGSTON PIKE STE C",
            "city": "FARRAGUT",
            "state": "TN",
            "postal_code": "379342890",
            "telephone_number": "865-986-5310",
            "fax_number": "865-986-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11121 KINGSTON PIKE STE C",
            "city": "FARRAGUT",
            "state": "TN",
            "postal_code": "379342890",
            "telephone_number": "865-986-5310",
            "fax_number": "865-986-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-20",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "8701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benchmark Healthcare Services LLC
• Richard Clyde Bensey, COTA/L
• Linda Bird, PTA
• Olivia Blair
• James Bolin, PHARM.D.
• Elizabeth Anne Brandon, P.T.
• Anna Marie Brenner
• Taylor Brooke Brown, PHARMD
• Ashley K Bruce, FNP
• James Kevin Buchanan, MD

• General Practice Dentistry in Farragut, TN
• Providers in Farragut, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.