Brad A Mayerle, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6896 Issued in OR

Practice address

14800 Kruse Oaks Blvd
Lake Oswego, OR 97035-8603

Phone

(503) 684-2944

Fax

(503) 624-6335

NPI assigned

Dec 16, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Brad A Mayerle Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Mayerle Dental PC

  • Dentist
  • Lake Oswego, OR
  • NPI 1912313610
  NPD (past) Authorized official

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

{
    "created_epoch": "1292457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292457600000",
    "number": "1851694640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14800 KRUSE OAKS BLVD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358603",
            "telephone_number": "503-684-2944",
            "fax_number": "503-624-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14800 KRUSE OAKS BLVD",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970358603",
            "telephone_number": "503-684-2944",
            "fax_number": "503-624-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYERLE",
        "first_name": "BRAD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-16",
        "last_updated": "2010-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRAD",
            "last_name": "MAYERLE",
            "middle_name": "A",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Terra Ann Mattson, MA MFT, LPC
• Maxem Health Urgent Care Lake Oswego
• Mayerle & Tydeman, LLC
• Mayerle Dental
• Mayerle Dental PC
• Rita Ellen Maynard, PSY.D.
• Ellen Kyte Mayock, MD
• Whitney McCann, LMT
• Alicia McCarthy, ND
• Jennifer McCarthy, LMT

• General Practice Dentistry in Lake Oswego, OR
• Providers in Lake Oswego, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 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.