Susan L Bracker, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

50-041045 Issued in NY

Practice address

1 Saredon PL
Suite 100
Rochester, NY 14606-4070

Phone

(585) 225-5600

Fax

(585) 225-6032

NPI assigned

Aug 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 NY

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

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811907140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 HEARTHSTONE RD",
            "city": "PITTSFORD",
            "state": "NY",
            "postal_code": "145341118",
            "telephone_number": "585-387-9314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SAREDON PL",
            "address_2": "SUITE 100",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146064070",
            "telephone_number": "585-225-5600",
            "fax_number": "585-225-6032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKER",
        "first_name": "SUSAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50-041045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joan D Bracaglia, MS
• Braces of Greece
• Adam Bracken, MD
• Brittany Bracken, RN
• Christie Sue Bracken
• Carolyn R Braddock, NP
• Dana Bradford
• Lacey Bradford
• Rochelle Bradford
• Shadel Bradford, LPN

• General Practice Dentistry in Rochester, NY
• Providers in Rochester, NY by specialty
• General Practice Dentistry in New York

• 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.
• 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.