Individual provider Active NPI

Bradford Perry Huffman, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Evans, GA
National Provider Identifier
1659637213
Registry record updated Jan 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
14454 Issued in GA
Practice address
7011 Evans Town Center Blvd
Evans, GA 30809-4315
Phone
(706) 724-8735
NPI assigned
Apr 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 14454 GA Primary

Addresses

Primary practice location

7011 Evans Town Center Blvd
Evans, GA 30809-4315

Mailing address

7011 Evans Town Center Blvd
Evans, GA 30809-4315
Phone (706) 724-8735

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170607002176 SC Practitioner - Maxillofacial Surgery 9830467257 Reassigns benefits to 1 organization
I20170718001462 GA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 9830467257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial Surgery
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Oral and Maxillofacial SurgeryGroup PAC ID 7618966573, 6 clinicians

Practice addresses (Care Compare)

101 Nut Grove Dr
North Augusta, SC 29841-2850
Phone (803) 278-2050

7011 Evans Town Ctr Blvd
Evans, GA 30809-4315
Phone (706) 724-8735

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery CurrentSince Apr 25, 2017 Accepting new patients

Locations

7011 Evans Town Center Blvd
Evans, GA 30809
Phone (706) 724-8735

1907 Pawnee St
Aiken, SC 29803
Phone (803) 649-3932

101 Nut Grove Dr
North Augusta, SC 29841
Phone (803) 278-2050

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1659637213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7011 EVANS TOWN CENTER BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094315",
            "telephone_number": "706-724-8735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7011 EVANS TOWN CENTER BLVD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094315",
            "telephone_number": "706-724-8735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUFFMAN",
        "first_name": "BRADFORD",
        "middle_name": "PERRY",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "GA",
            "license": "14454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.