Jesse Campbell Bradford, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8780 Issued in NC

Practice address

319 S Sharon Amity Rd Ste 100
Charlotte, NC 28211-2834

Phone

(704) 534-0528

NPI assigned

Jul 17, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Jesse C. Bradford, D.D.S., P.L.L.C.

  • General Practice Dentistry
  • Charlotte, NC
  • NPI 1114340700
  NPD (past) Authorized official

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

{
    "created_epoch": "1247788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390867200000",
    "number": "1730319302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S SHARON AMITY RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112834",
            "telephone_number": "704-534-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S SHARON AMITY RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112834",
            "telephone_number": "704-534-0528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRADFORD",
        "first_name": "JESSE",
        "middle_name": "CAMPBELL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-17",
        "last_updated": "2014-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "8780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas Wayne Bradberry, D.C.
• William Timothy Brader, MD
• Bradford L Picot, DDS, P.a.
• Bradford OB/GYN
• Grace Bradford
• Bradley a Wruble OD PLLC
• Bradley-Reid Corporation
• Alana Gabrielle Bradley
• April Bradley, RN, MSN
• Davis Burr Bradley, DPT

• General Practice Dentistry in Charlotte, NC
• Providers in Charlotte, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.