Janine Marie Bradley, RDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

DH.000906087 Issued in CO

Practice address

410 Macon Ave
Canon City, CO 81212-3225

Phone

(719) 276-0117

NPI assigned

Dec 3, 2018

Sex

Female

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

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

{
    "created_epoch": "1543795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1407326440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 S INDIAN BEND DR",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810076158",
            "telephone_number": "719-276-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MACON AVE",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812123225",
            "telephone_number": "719-276-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "JANINE",
        "middle_name": "MARIE",
        "credential": "RDH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-03",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CO",
            "license": "DH.000906087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Clyde Bosse, O.D.
• Alec Douglas Bower, D.O.
• Kathleen Boyd, FNP
• Deborah Bradfield, LCSW
• Bradley J. Schluter, D.D.S. Inc.
• Gina Brekke
• Judith Anne Bridgeman, LCSW
• Bright Eyes Vision Clinic PC a Colorado Professional Corporation
• Tanja Britton
• Roberta Jo Broman, R.D.H.

• Dental Hygienist in Canon City, CO
• Providers in Canon City, CO by specialty
• Dental Hygienist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.