NPIMap

Organization Active NPI

Bradley Dental

  • General Practice Dentistry
  • Warren, MI
National Provider Identifier
1770848129
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
15917 Issued in MI
Legal business name
BRADLEY DENTAL
Practice address
21635 Ryan Rd
Warren, MI 48091-2788
Phone
(586) 757-7540
NPI assigned
Jul 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Authorized official

Name
Dana Horsch
Title
Manager
Phone
(586) 757-7540

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 15917 MI Primary
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 2451596 MI
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X MI
Customized Equipment (DME) 332BC3200X 15917 MI

Addresses

Primary practice location

21635 Ryan Rd
Warren, MI 48091-2788

Mailing address

21635 Ryan Rd
Warren, MI 48091-2788
Phone (586) 757-7540

National Provider Directory

National Provider Directory
Tax ID family
Bradley Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1770848129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21635 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912788",
            "telephone_number": "586-757-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21635 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480912788",
            "telephone_number": "586-757-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-11",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "HORSCH",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-757-7540"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "15917",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MI",
            "license": "2451596",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MI",
            "license": "15917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.