J. Dwight Bradshaw DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

J. DWIGHT BRADSHAW DDS

Practice address

5501 Bennetts Pasture Rd Ste D
Suffolk, VA 23435-1500

Phone

(757) 484-1444

Fax

(757) 484-3712

NPI assigned

Oct 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. J.Dwight Bradshaw, DDS

Title

Owner

Phone

(757) 484-1444

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.

• Timothy Ferramosca, DDS

  • Dentist
  • Suffolk, VA
  • NPI 1619180114
  NPD (past)

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

{
    "created_epoch": "1224633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1568614584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 BENNETTS PASTURE RD STE D",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351500",
            "telephone_number": "757-484-1444",
            "fax_number": "757-484-3712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 BENNETTS PASTURE RD STE D",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "234351500",
            "telephone_number": "757-484-1444",
            "fax_number": "757-484-3712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. DWIGHT BRADSHAW DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-22",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "BRADSHAW",
        "authorized_official_first_name": "J.DWIGHT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-484-1444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Suffolk, VA
• Providers in Suffolk, VA by specialty
• General Practice Dentistry in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; 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.