Bradley Johnson D.M.D., M.S.D., LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BRADLEY JOHNSON D.M.D., M.S.D., LLC

Practice address

7288 Mentor Ave
Mentor, OH 44060-7578

Phone

(440) 946-0088

NPI assigned

Dec 16, 2020

Last updated

Dec 16, 2020By 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

Bradley R Johnson, D.M.D, M.S.D.NPI 1154601839

Title

Orthodontist

Phone

(440) 946-0088

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, and the practitioner matching its NPPES authorized official.

• Bradley R Johnson, D.M.D., M.S.D.

  • Dentist
  • Mentor, OH
  • NPI 1154601839
  NPD Authorized official

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

{
    "created_epoch": "1608076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608076800000",
    "number": "1710573548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 LANDER RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440221434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7288 MENTOR AVE",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440607578",
            "telephone_number": "440-946-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY JOHNSON D.M.D., M.S.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-16",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "440-946-0088",
        "authorized_official_credential": "D.M.D, M.S.D."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Andrew Boyle Sr., OD
• James Matthew Bozic, O.D.
• Laura B Bracknell, DO
• Courtney Bradac
• Barry Rex Bradford, D.C.
• Ariel E. Braff, QMHS
• Megan Branstein
• Catharine Brasdovich, LPC
• Diamond Brasmon, LPC
• Braxton Home Healthcare

• Dental Clinic/Center in Mentor, OH
• Providers in Mentor, OH by specialty
• Dental Clinic/Center in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.