Individual provider Active NPI

Bradford Hugh Dickey, DDS

  • General Practice Dentistry
  • Lodi, CA
National Provider Identifier
1386748887
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
32821 Issued in CA
Practice address
801 South Ham Lane
Suite L
Lodi, CA 95242-7502
Phone
(209) 334-0630
Fax
(209) 334-0541
NPI assigned
Sep 13, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 32821 CA Primary

Addresses

Primary practice location

801 South Ham Lane
Suite L
Lodi, CA 95242-7502

Mailing address

801 South Ham Lane
Suite L
Lodi, CA 95242-7502
Phone (209) 334-0630

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
32821CAMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Yusuke Suzuki D M D Inc General Practice PastSince Jan 7, 2024 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386748887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 SOUTH HAM LANE",
            "address_2": "SUITE L",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952427502",
            "telephone_number": "209-334-0630",
            "fax_number": "209-334-0541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 SOUTH HAM LANE",
            "address_2": "SUITE L",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952427502",
            "telephone_number": "209-334-0630",
            "fax_number": "209-334-0541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKEY",
        "first_name": "BRADFORD",
        "middle_name": "HUGH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lodi, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.