Matthew Brady, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

00201885 Issued in CO

Practice address

7613 Esther Cir
Frederick, CO 80504-5881

Phone

(757) 462-6602

NPI assigned

Jan 27, 2006

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Firestone Pediatric Dentistry and Orthodontics

  • Pediatric Dentistry
  • Frederick, CO
  • NPI 1558757260
  NPD Authorized official
• Garlock Firestone Orthodontics LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Frederick, CO
  • NPI 1649904236
  NPD

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on May 24, 2024.

{
    "created_epoch": "1138320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1477524643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2381 ANTELOPE RIDGE TRL",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801384235",
            "telephone_number": "757-462-6602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7613 ESTHER CIR",
            "city": "FREDERICK",
            "state": "CO",
            "postal_code": "805045881",
            "telephone_number": "757-462-6602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADY",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-27",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D8112",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CO",
            "license": "00201885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61086541",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara Lucille Benegas
• Dustin Berg, RN, BSN
• Jeffrey Berger, O.D.
• Derrick Shilo Betting, LPCC
• Abby Elizabeth Bohall, CCC-SLP
• Randy Phillip Breunig, LPC
• Riley Nicole Buis, COTA/L
• Carolyn Deolinda Bullock, DDS
• Laura Michele Camp, MSN, NP
• Lindsay Campbell

• All providers in Frederick, CO
• Pediatric Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; 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.