Stephen Dominick Brattelli, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI01515800 Issued in NJ

Practice address

15 Colby Ave
Stratford, NJ 08084-1028

Phone

(856) 782-0103

NPI assigned

Jan 13, 2007

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

Enrolled in NJ

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": "1168646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452902400000",
    "number": "1376694844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 SHENANDOAH DR",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080433308",
            "telephone_number": "856-534-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 COLBY AVE",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841028",
            "telephone_number": "856-782-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRATTELLI",
        "first_name": "STEPHEN",
        "middle_name": "DOMINICK",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-13",
        "last_updated": "2016-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01515800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Valerie Blakney, LPN
• Lisa Marie Bodenheimer, LSW
• Garrett James Borger, DO
• Alexander R Bourneuf, RPH
• Mikayla Shaye Brackett
• Linda S Brecher, DO
• Rebecca Brecker, RPH
• Kristin M Briggs, ED.D.
• Ben Brik, DO
• Heather L Brooks, M.A.

• Dentist in Stratford, NJ
• Providers in Stratford, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2016; 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.