Active NPI
Edward Bradford, DDS
- General Practice Dentistry
- Birmingham, AL
National Provider Identifier
1407944200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 4686
- Practice address
- 1400 6TH Ave S
Jefferson County Health Dept-Central Dental Clinic
Birmingham, AL 35233-1502 - Phone
- (205) 930-1422
- Fax
- (205) 930-1448
- NPI assigned
- Oct 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 4686 | AL | Primary |
Addresses
Primary practice location
1400 6TH Ave S
Jefferson County Health Dept-Central Dental Clinic
Birmingham, AL 35233-1502
Mailing address
1400 6TH Ave S
Jefferson County Health Dept-Central Dental Clinic
Birmingham, AL 35233-1502
Phone (205) 930-1422
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51513061BRA | Other | AL | BLUE CROSS#EASTERN DENTAL |
| 51513060BRA | Other | AL | BLUECROSS#WESTERN DENTAL |
| 51513055BRA | Other | AL | BLUE CROSS#-CENTRAL DENTA |
| 51513056BRA | Other | AL | BLUE CROSS#-BESSEMER DENT |
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 |
|---|---|---|---|
| 4686 | AL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1407944200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 6TH AVE S",
"address_2": "JEFFERSON COUNTY HEALTH DEPT-CENTRAL DENTAL CLINIC",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352331502",
"telephone_number": "205-930-1422",
"fax_number": "205-930-1448"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 6TH AVE S",
"address_2": "JEFFERSON COUNTY HEALTH DEPT-CENTRAL DENTAL CLINIC",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352331502",
"telephone_number": "205-930-1422",
"fax_number": "205-930-1448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADFORD",
"first_name": "EDWARD",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-10",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AL",
"license": "4686",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS#EASTERN DENTAL",
"identifier": "51513061BRA",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS#WESTERN DENTAL",
"identifier": "51513060BRA",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS#-CENTRAL DENTA",
"identifier": "51513055BRA",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS#-BESSEMER DENT",
"identifier": "51513056BRA",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.