Jon P Bradrick, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

30018571 Issued in OH

Practice address

2500 Metrohealth Dr
MHMC-Surgery/Oral & Max
Cleveland, OH 44109-1900

Phone

(216) 778-4488

NPI assigned

Jun 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477581908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "address_2": "MHMC-SURGERY/ORAL & MAX",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 METROHEALTH DR",
            "address_2": "MHMC-SURGERY/ORAL & MAX",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441091900",
            "telephone_number": "216-778-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADRICK",
        "first_name": "JON",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OH",
            "license": "30018571",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "TX 19114",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0696528",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linda D Bradley, MD
• Maureen Mounce Bradley, LCSW
• Princess Lapaula Bradley
• Sarah Vanorden Bradley, MD PHD
• Tamika Nicole Bradley
• Jared Andrew Bradshaw, D.O.
• William Bradshaw, ACNP
• Elizabeth Ann Brady-Toomey, PCC-S
• Benjamin Francis Brady
• Karen M Brady, NURSE PRACTITIONER

• All providers in Cleveland, OH
• Oral and Maxillofacial Surgery (Dentist) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.