John M Bracken PC

Primary specialty

DentistTaxonomy code 122300000X

License

749 Issued in AZ

Legal business name

JOHN M BRACKEN PC

Practice address

213 East Monterey Way
Phoenix, AZ 85012-2619

Phone

(602) 265-6456

Fax

(602) 265-6456

NPI assigned

Mar 15, 2007

Organization subpart

No

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

Authorized official

Name

John Melvin Bracken, DDS

Title

President

Phone

(602) 265-6456

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689708273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 EAST MONTEREY WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122619",
            "telephone_number": "602-265-6456",
            "fax_number": "602-265-6456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 EAST MONTEREY WAY",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850122619",
            "telephone_number": "602-265-6456",
            "fax_number": "602-265-6456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M BRACKEN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRACKEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MELVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "602-265-6456",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "AZ",
            "license": "749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Dentist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.