Kelli Brady DDS LLC

Primary specialty

DentistTaxonomy code 122300000X

License

22D102398600 Issued in NJ

Legal business name

KELLI BRADY DDS LLC

Practice address

180 Old Tappan Rd
BLDG 6
Old Tappan, NJ 07675-7052

Phone

(201) 768-5553

Fax

(201) 768-7601

NPI assigned

Jan 9, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Kelli Brady, D.D.S.

Title

Owner/Dentist

Phone

(201) 768-5553

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1357689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357689600000",
    "number": "1548507643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 OLD TAPPAN RD",
            "address_2": "BLDG 6",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757052",
            "telephone_number": "201-768-5553",
            "fax_number": "201-768-7601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 OLD TAPPAN RD",
            "address_2": "BLDG 6",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757052",
            "telephone_number": "201-768-5553",
            "fax_number": "201-768-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLI BRADY DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-09",
        "last_updated": "2013-01-09",
        "status": "A",
        "authorized_official_last_name": "BRADY",
        "authorized_official_first_name": "KELLI",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "201-768-5553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102398600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Maria Heifetz, OTR
• Icurewellness
• Olga Ivashkov, L.AC.
• David Jenkins, D.M.D., M.S.D.
• Youn Woo Jung
• Sarah Kim
• Susan T Kwee, D.D.S.
• Barbara Ford Lanoil, MSW
• Gary John Larocca, D.C.
• Drew Morgan Lebovich, APN

• Dentist in Old Tappan, NJ
• Providers in Old Tappan, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; 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.