Active NPI
Susan M Bradley, RDH
- Dental Hygienist
- Colorado Springs, CO
National Provider Identifier
1396187084
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 43257
- Practice address
- 340 Printers Pkwy
Colorado Springs, CO 80910-3190 - Phone
- (719) 687-4460
- NPI assigned
- Jul 23, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 905226 | CO | |
| Dental Hygienist | 124Q00000X | 43257 | CA | Primary |
Addresses
Primary practice location
340 Printers Pkwy
Colorado Springs, CO 80910-3190
Mailing address
34 Hybrook Rd South
Divide, CO 80814
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
| License | State | Type | Specialty |
|---|---|---|---|
| 43257 | CA | MD | General Practice Dentistry |
| 905226 | CO | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374537600000",
"number": "1396187084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 HYBROOK RD SOUTH",
"city": "DIVIDE",
"state": "CO",
"postal_code": "80814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 PRINTERS PKWY",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809103190",
"telephone_number": "719-687-4460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "SUSAN",
"middle_name": "M",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-07-23",
"last_updated": "2013-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CO",
"license": "905226",
"primary": false
},
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "43257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado Springs, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.