Charles Pedigo Bradshaw, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4154 Issued in KY

Practice address

220 Conway St
Suite 2
Frankfort, KY 40601-2748

Phone

(502) 223-4120

Fax

(502) 223-4166

NPI assigned

Jun 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1538361456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CONWAY ST",
            "address_2": "SUITE 2",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406012748",
            "telephone_number": "502-223-4120",
            "fax_number": "502-223-4166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 CONWAY ST",
            "address_2": "SUITE 2",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406012748",
            "telephone_number": "502-223-4120",
            "fax_number": "502-223-4166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADSHAW",
        "first_name": "CHARLES",
        "middle_name": "PEDIGO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Callista Boyce
• Yuri Boyechko, M.D.
• Bradford Square Health Center LLC (Bradford Square Center)
• Bradford Square Nursing, LLC (Bradford Square Care and Rehabilitation Center)
• Tiara Bradley
• Amber L Bragg, BCBA
• Jennifer Ann Brand, MSW
• Erika Faith Branham, CPHT
• Jakob Brannock, PHARMD
• Bray Pharmacy Inc (Capital Pharmacy and Medical Equipment)

• General Practice Dentistry in Frankfort, KY
• Providers in Frankfort, KY by specialty
• General Practice Dentistry in Kentucky

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

Verify at the official NPI Registry.