Brad W Porter, DDS,MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN4389 Issued in FL

Practice address

1097 Douglas Ave
Altamonte Springs, FL 32714-5211

Phone

(407) 834-4500

Fax

(407) 862-6544

NPI assigned

Mar 19, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770608044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 REGAL CREST DR",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327793186",
            "telephone_number": "407-833-9333",
            "fax_number": "407-852-6544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1097 DOUGLAS AVE",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327145211",
            "telephone_number": "407-834-4500",
            "fax_number": "407-862-6544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "BRAD",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS,MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN4389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cicely Elizabeth Poleon
• Sebina Ponjevic
• Nicholas Kent Pooler, PT
• Raaj Kumar Popli, MD
• Arrington Porter, PT, DPT
• Ross William Porter
• Jacquelin Ann Portino, LCSW
• Positive Behavioral Solutions LLC
• Nicholas Potter
• Phyllis Chovoor Potter

• Orthodontics and Dentofacial Orthopedics Dentistry in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.