Bradley T Frederick DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRADLEY T FREDERICK DMD LLC

Practice address

1935 Apple Blossom Dr
Floyds Knobs, IN 47119-9025

Phone

(502) 552-4559

NPI assigned

Oct 21, 2024

Organization subpart

No

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

Authorized official

Name

Bradley Frederick, DMD

Title

Manager

Phone

(502) 552-4559

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1487475737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1935 APPLE BLOSSOM DR",
            "city": "FLOYDS KNOBS",
            "state": "IN",
            "postal_code": "471199025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1935 APPLE BLOSSOM DR",
            "city": "FLOYDS KNOBS",
            "state": "IN",
            "postal_code": "471199025",
            "telephone_number": "502-552-4559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY T FREDERICK DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-20",
        "status": "A",
        "authorized_official_last_name": "FREDERICK",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "502-552-4559",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Everett Bickers, MD
• Rex G Bickers, MD
• Cindy Sue Boaz, M.S., CCC-SLP
• Maria Agnes Boha, MD
• Ashton Bowles
• Aleshia Marie Brown, PHARMD
• Sarah Brown, OTD, OTR/L
• Janel Mary Buechler, MSN, FNP-BC
• Calvin Duke Enterprises
• Jo Ellen Carr, M.A.CCC-SLP

• All providers in Floyds Knobs, IN
• Dental Clinic/Center in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.