Jaclyn Bradle DDS Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

61315 Issued in CA

Legal business name

JACLYN BRADLE DDS INC.

Practice address

8639 1/2 Baseline Rd
Rancho Cucamonga, CA 91730-1111

Phone

(626) 290-7106

NPI assigned

May 3, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Jaclyn Bradle, DDSNPI 1891055109

Title

President

Phone

(626) 290-7106

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Bradle, D.D.S.

  • General Practice Dentistry
  • Rancho Cucamonga, CA
  • NPI 1891055109
  NPD (past) Authorized official

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

{
    "created_epoch": "1399075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399075200000",
    "number": "1891105540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 N BURNABY DR",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413131",
            "telephone_number": "626-290-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8639 1/2 BASELINE RD",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917301111",
            "telephone_number": "626-290-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACLYN BRADLE DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-03",
        "last_updated": "2014-05-03",
        "status": "A",
        "authorized_official_last_name": "BRADLE",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-290-7106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micolya Jackson
• N'Deya Shontae Jackson
• Raymond Jackson
• Susan H Jackson, LMFT
• Yvonne Jackson, DMFT, LMFT
• Suby Jacob
• Saul Jacobson, MS
• Diane Marie Jacquez, RN
• Kenneth H Jahng, MD
• Daniela Jaime-Apolonio

• General Practice Dentistry in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.