Bradley Miles Beisiegel, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

11794 Issued in TN

Practice address

1509 Congress Pkwy S
Athens, TN 37303-2803

Phone

(423) 381-6199

NPI assigned

Aug 2, 2020

Last updated

Apr 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Polumbo Family Dentistry Inc

  • Dental Clinic/Center
  • Grass Valley, CA
  • NPI 1528885381
  NPD (past)

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

{
    "created_epoch": "1596326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1720698079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1361 BLAKE STONE DR NW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373121870",
            "telephone_number": "802-355-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1509 CONGRESS PKWY S",
            "city": "ATHENS",
            "state": "TN",
            "postal_code": "373032803",
            "telephone_number": "423-381-6199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEISIEGEL",
        "first_name": "BRADLEY",
        "middle_name": "MILES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-02",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "11794",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "105079",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thelma Jean Barr, MASTERS COUNSELING
• Douglas R Barrow, CRNA
• Frederick James Barry, MD
• Nicholas Joseph Beaumonte Jr., FNP-C
• Behavioral Concepts
• Clair L. Bello III, DPM
• Benchmark Healthcare Services LLC
• Daniel Asberry Benson, DPT
• Melissa Kay Benson, RN, BSN
• Berry Family Care

• Dentist in Athens, TN
• Providers in Athens, TN by specialty
• Dentist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.