Bradley W. Wilkinson

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DS005140 Issued in TN

Legal business name

BRADLEY W. WILKINSON

Doing business as

Pediatric Dental Specialties

Practice address

5040 Sanderlin Ave Ste 101
Memphis, TN 38117-4374

Phone

(901) 761-5155

Fax

(901) 761-5130

NPI assigned

Jan 14, 2010

Organization subpart

No

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

Authorized official

Name

Bradley W Wilkinson, DDS

Title

Dentist

Phone

(901) 761-5155

Specialties & licenses 1

Addresses

Other names 1

• Pediatric Dental Specialties Doing business as

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

{
    "created_epoch": "1263427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263427200000",
    "number": "1740510775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 SANDERLIN AVE STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174374",
            "telephone_number": "901-761-5155",
            "fax_number": "901-761-5130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 SANDERLIN AVE STE 101",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381174374",
            "telephone_number": "901-761-5155",
            "fax_number": "901-761-5130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY W. WILKINSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-14",
        "last_updated": "2010-01-14",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "901-761-5155",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "TN",
            "license": "DS005140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Specialties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anita Carmen Bradford, LADAC
• Jacque L Bradford, PT
• Jeremy Lynn Bradford, P.T.
• Marcia Bradford, M.D.
• Selena Bradford
• Ashley Wallace Bradley, PHARMD
• Bobby Deshaun Bradley, MD
• Breasia Bradley
• Bridgett Renee Bradley
• Christina Bradley

• Dental Clinic/Center in Memphis, TN
• Providers in Memphis, TN by specialty
• Dental Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; 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.