Brad Lawrence Hart, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30750 Issued in CA

Practice address

1785 San Carlos Ave
Ste 1
San Carlos, CA 94070-2026

Phone

(650) 593-7806

Fax

(650) 593-6585

NPI assigned

Jun 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 16, 2016 through May 16, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487659751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 SAN CARLOS AVE",
            "address_2": "STE 1",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702026",
            "telephone_number": "650-593-7806",
            "fax_number": "650-593-6585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 SAN CARLOS AVE",
            "address_2": "STE 1",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702026",
            "telephone_number": "650-593-7806",
            "fax_number": "650-593-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "BRAD",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "30750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kavitha Hari
• Lamar Devereay Harraway
• Aimee Leigh Harris, MD
• Sabina Harris, MS, LMFT
• Steven Jeffrey Harris, M.D.
• Emily Alice Hart, BA
• Julie Haslam
• Islam Hassanein
• Alyssa Hayashi, M.S. CCC-SLP
• Zachary Erhard Held, D.D.S.

• General Practice Dentistry in San Carlos, CA
• Providers in San Carlos, CA by specialty
• General Practice Dentistry in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.