Bradley Tyler Belous, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DS040832 Issued in PA

Practice address

600 E Marshall St Ste 106
West Chester, PA 19380-4443

Phone

(484) 999-0956

NPI assigned

May 27, 2016

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

Enrolled in PA

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

State licenses

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

{
    "created_epoch": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1528416732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 E MARSHALL ST STE 106",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804443",
            "telephone_number": "484-999-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 E MARSHALL ST STE 106",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193804443",
            "telephone_number": "484-999-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELOUS",
        "first_name": "BRADLEY",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS040832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Bell
• Sierra Bell, CRNP
• Katie Emma Bellace
• Cheryl R Bellaire, M D L L C
• Vincent John Bellwoar, PH.D.
• Benchmark Wellington SNF Operator LLC
• Jacqueline F Bender, OTR/L
• Benedict J Parenti DDS PC
• John Benedict
• Intissar A Benhalim, LSW

• Oral and Maxillofacial Surgery (Dentist) in West Chester, PA
• Providers in West Chester, PA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.