Active NPI
Bradley Lynn Townsend, DDS
- Periodontics
- Boise, ID
National Provider Identifier
1700994852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 06580
- Practice address
- 6019 N. Eagle Rd.
Boise, ID 83713 - Phone
- (208) 377-2777
- Fax
- (208) 377-3075
- NPI assigned
- Aug 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 5910 | CO | |
| Periodontics | 1223P0300X | 06580 | IA | Primary |
Addresses
Primary practice location
6019 N. Eagle Rd.
Boise, ID 83713
Mailing address
6019 N. Eagle Rd.
Boise, ID 83713
Phone (208) 377-2777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06580 | IA | MD | Chiropractor |
| 5910 | CO | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538006400000",
"number": "1700994852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6019 N. EAGLE RD.",
"city": "BOISE",
"state": "ID",
"postal_code": "83713",
"telephone_number": "208-377-2777",
"fax_number": "208-377-3075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6019 N. EAGLE RD.",
"city": "BOISE",
"state": "ID",
"postal_code": "83713",
"telephone_number": "208-377-2777",
"fax_number": "208-377-3075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOWNSEND",
"first_name": "BRADLEY",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-28",
"last_updated": "2018-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CO",
"license": "5910",
"primary": false
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IA",
"license": "06580",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.