Bradley Ross Carn, D.M.D., MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

2018228864 Issued in MO

Practice address

222 S Woods Mill Rd Ste 720N
Chesterfield, MO 63017

Phone

(314) 434-0493

Fax

(314) 434-7883

NPI assigned

Apr 11, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 14, 2023 through Feb 14, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1447516794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD STE 720N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173650",
            "telephone_number": "314-434-0493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S WOODS MILL RD STE 720N",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "63017",
            "telephone_number": "314-434-0493",
            "fax_number": "314-434-7883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11810 Gravois Rd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631271829",
            "country_code": "US",
            "telephone_number": "314-842-5340",
            "fax_number": "314-849-9567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6 Jungermann Cir Ste 202",
            "address_purpose": "LOCATION",
            "city": "Saint Peters",
            "state": "MO",
            "postal_code": "633761625",
            "country_code": "US",
            "telephone_number": "636-928-1222",
            "fax_number": "636-928-2293",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARN",
        "first_name": "BRADLEY",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.M.D., MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MO",
            "license": "2018008864",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "D5998",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "MO",
            "license": "2018228864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cardiothoracic Surgery, LLC
• Care Homecare, LLC
• Victoria Lynn Carlson-Casaregola, MA, CCC-SLP
• Justine L Carlson, LCSW
• Cheri M Carmody, RN BC ANP
• Carole Myre Counseling LLC
• Carolynn F Wolff DMD PC
• Tracey Ann Carpenter, NP-C
• Lisa Ann Carr, SPEECH PATHOLOGIST,
• Oscar A Cartaya, M.D.

• Oral & Maxillofacial Surgery (D.M.D.) in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.