Bradford R Mattison DMD PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN1857389 Issued in MA

Legal business name

BRADFORD R MATTISON DMD PLLC

Practice address

1 Hollis St Ste 340
Wellesley, MA 02482-4672

Phone

(781) 235-5404

NPI assigned

Jun 20, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Bradford R Mattison, DMDNPI 1386198422

Title

Owner

Phone

(617) 930-6493

Specialties & licenses 1

Addresses

Other names 1

• Wellesley Square Dental Doing business as

Locations

Practitioners 2

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

• Bradford Richard Mattison, D.M.D.

  • Dentist
  • Wellesley, MA
  • NPI 1386198422
  NPD (past) Authorized official
• Douglas K. Vassos, D.M.D.

  • General Practice Dentistry
  • Wellesley, MA
  • NPI 1023049871
  NPD (past)

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

{
    "created_epoch": "1529452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1477047710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 LANGLEY RD # 2",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024592062",
            "telephone_number": "617-930-6493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOLLIS ST STE 340",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024824672",
            "telephone_number": "781-235-5404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADFORD R MATTISON DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "MATTISON",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-930-6493",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1857389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellesley Square Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paul Bottom, M.S CCC-SLP
• Andrew J. Bouley, M.D.
• Regina E. Bower, LICSW
• Thalia Rei Bowie, DNP, APRN, FNP-C
• Melanie Boyac
• Debra A Bradford, NP
• Elizabeth Ruth Braeley
• Brain Energy, PLLC
• Maureen Linnane Branch, LICSW
• Kevin H Braney

• General Practice Dentistry in Wellesley, MA
• Providers in Wellesley, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.