Bravosmile PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BRAVOSMILE PC

Practice address

2075 SW 1St Ave Ste 2K
Portland, OR 97201-5314

Phone

(503) 222-3591

Fax

(503) 222-4496

NPI assigned

Jul 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Nancy M Candee

Title

Business Manager

Phone

(503) 222-3591

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Jacob Flath, DMD

  • General Practice Dentistry
  • Portland, OR
  • NPI 1942320536
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1518998533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2075 SW 1ST AVE STE 2K",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015314",
            "telephone_number": "503-222-3591",
            "fax_number": "503-222-4496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 SW 1ST AVE STE 2K",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015314",
            "telephone_number": "503-222-3591",
            "fax_number": "503-222-4496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAVOSMILE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANDEE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "503-222-3591",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanna Braverman, OTR/L
• Bravestone House LLC
• Acacia Marie Bravo, CSWA/QMHP-R
• Nia Bravo
• Zoya Rochelle Bravo
• Nicole Rae Brawley
• Julien James Brawn, RN
• Diane Lynn Braxmeyer Downey, DNP
• Catherine Braxton, LMT
• Dorothea Braxton

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.