Bradley Jay Morlock, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D2072PE Issued in ID

Practice address

3323 4TH St
Lewiston, ID 83501-4423

Phone

(208) 743-1114

Fax

(208) 743-0120

NPI assigned

Sep 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

• Bradley J. Morlock, D.D.S.,P.C.

  • Periodontics
  • Lewiston, ID
  • NPI 1710096896
  Authorized official Same address or phone

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497853220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3323 4TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014423",
            "telephone_number": "208-743-1114",
            "fax_number": "208-743-0120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3323 4TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835014423",
            "telephone_number": "208-743-1114",
            "fax_number": "208-743-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORLOCK",
        "first_name": "BRADLEY",
        "middle_name": "JAY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "ID",
            "license": "D2072PE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "D2072 PE",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lois Elizabeth Moree, LMT
• Christopher Al Moreno, M.D.
• Clinton R Morgan, MD
• John Carl Morgenstern, M.D.
• Wendy Elizabeth Morley, CRNA
• Katherine L. Morris, NPC
• Ryan Morris, PA
• Charles Morrison, BS, IS, BSW
• Brian Morrow, LCPC
• Jared Charles Morton, M.D.

• Periodontics in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Periodontics in Idaho

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.