Doyle Alan Bradshaw, DDS
Individual provider Active NPI Public Health Dentistry · Hoopa, CA
NPI 1417007253 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1417007253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Public Health Dentistry 1223D0001X
- License
- 32030 (CA)
- Practice address
- 1201 Airport Rd
Hoopa, CA 95546 - Phone
- (530) 625-4261
- Fax
- (530) 625-5261
- NPI assigned
- Jan 12, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 32030 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health Dentistry | 1223D0001X | 32030 | CA | Yes |
Addresses
Primary practice location
1201 Airport Rd
Hoopa, CA 95546
Mailing address
PO Box 1100
Airport Rd
Hoopa, CA 95546-1100
Phone (530) 625-4261
Other providers in Hoopa, CA
All providers in Hoopa, CA · Public Health Dentistry in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.