Richard Brady Perdue, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D1247 Issued in SD

Practice address

2606 Elderberry Blvd
Rapid City, SD 57703

Phone

(605) 737-3150

Fax

(605) 348-3201

NPI assigned

Jul 26, 2019

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

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.

• R Brady Perdue DDS, PLLC

  • General Practice Dentistry
  • Holladay, UT
  • NPI 1194571869
  NPD Authorized official

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

{
    "created_epoch": "1564099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1376197533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 MAPLE AVE",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577012931",
            "telephone_number": "605-737-3150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2606 ELDERBERRY BLVD",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "57703",
            "telephone_number": "605-737-3150",
            "fax_number": "605-348-3201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577012931",
            "country_code": "US",
            "telephone_number": "605-737-3150",
            "fax_number": "605-348-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERDUE",
        "first_name": "RICHARD",
        "middle_name": "BRADY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-26",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "D1247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Rae Pengra, PT, DPT
• Pennington County Auditor
• Pennington County Sheriff'S Office
• Jessica Pennington
• Lisa Ann Pentecost, CNP
• Performance Respiratory, Inc.
• Bryton Evan Perman, MD
• Mark William Perrenoud, PH.D.
• Jill Perry
• Joy Person, OT

• General Practice Dentistry in Rapid City, SD
• Providers in Rapid City, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.