NPIMap

Organization Active NPI

Dr. Bradley Degroote D.D.S., LLC

  • Dental Clinic/Center
  • Florence, AL
National Provider Identifier
1407587066
Registry record updated Jun 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DR. BRADLEY DEGROOTE D.D.S., LLC
Practice address
1903 Bruin Dr
Florence, AL 35630-1461
Phone
(256) 767-3228
NPI assigned
Jun 23, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2022

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

Authorized official

Name
Dr. Bradley Degroote, DDSNPI 1093803967
Title
Dentist
Phone
(256) 767-3228

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1903 Bruin Dr
Florence, AL 35630-1461

Mailing address

1903 Bruin Dr
Florence, AL 35630-1461
Phone (256) 767-3228

National Provider Directory

National Provider Directory

Locations

1903 Bruin Dr
Florence, AL 35630
Phone (256) 764-1858

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655942400000",
    "number": "1407587066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1903 BRUIN DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301461",
            "telephone_number": "256-767-3228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1903 BRUIN DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301461",
            "telephone_number": "256-767-3228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. BRADLEY DEGROOTE D.D.S., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A",
        "authorized_official_last_name": "DEGROOTE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "256-767-3228",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; 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.