Active NPI
Richard Scott Braverman, D.D.S.
- General Practice Dentistry
- Dalton, GA
National Provider Identifier
1861650004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 10878
- Practice address
- 2107 E Walnut Ave
Suite a
Dalton, GA 30721-4552 - Phone
- (706) 428-0235
- NPI assigned
- May 23, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10878 | GA | Primary |
Addresses
Primary practice location
2107 E Walnut Ave
Suite a
Dalton, GA 30721-4552
Mailing address
2107 E Walnut Ave.
Dalton, GA 30721
Phone (706) 428-0235
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10878 | GA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Candler Road Dental, PC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Dalton, GA
- NPI 1295823003
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373328000000",
"number": "1861650004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2107 E WALNUT AVE.",
"city": "DALTON",
"state": "GA",
"postal_code": "30721",
"telephone_number": "706-428-0235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2107 E WALNUT AVE",
"address_2": "SUITE A",
"city": "DALTON",
"state": "GA",
"postal_code": "307214552",
"telephone_number": "706-428-0235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRAVERMAN",
"first_name": "RICHARD",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-23",
"last_updated": "2013-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "GA",
"license": "10878",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dalton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.