Timothy Bradberry DMD, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TIMOTHY BRADBERRY DMD, PLLC

Doing business as

North Jacksonville Complete Dentistry

Practice address

1566 Dunn Ave # 3
Jacksonville, FL 32218-4734

Phone

(904) 751-4958

Fax

(904) 751-5330

NPI assigned

Aug 23, 2024

Last updated

Aug 23, 2024By 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

Dr. Timothy Bradberry, DMDNPI 1134673056

Title

Dentist/Owner

Phone

(904) 553-6474

Specialties & licenses 1

Addresses

Other names 1

• North Jacksonville Complete Dentistry Doing business as

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.

• Timothy Bradberry, DMD

  • General Practice Dentistry
  • Jacksonville, FL
  • NPI 1134673056
  NPD Authorized official

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

{
    "created_epoch": "1724371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724371200000",
    "number": "1558194530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1566 DUNN AVE # 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184734",
            "fax_number": "904-751-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 DUNN AVE # 3",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322184734",
            "telephone_number": "904-751-4958",
            "fax_number": "904-751-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY BRADBERRY DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-23",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A",
        "authorized_official_last_name": "BRADBERRY",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "904-553-6474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Jacksonville Complete Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Timmon, RN
• Laura M Timmons, ARNP
• Tawanna Denise Timmons, CPT, MA
• Cassandra Timo
• Melissa R Timonere, LD/N
• Timothy J Parker DMD PA
• Timothy L Wyatt MD PA
• Tina Sines (Jacks Therapy Center LLC)
• Karen Tinaglia, OTR/L, CSRS
• Dovie Nile Tinana, ARNP

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; 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.