NPIMap

Organization Active NPI

Bradley a Purcell D.D.S. M.S. & Ryan M. Mizumoto D.M.D., M.S., Inc

Doing business as Spectrum Dental & Prosthodontics

  • Prosthodontics
  • Worthington, OH
National Provider Identifier
1912250135
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
15174 Issued in MI
Legal business name
BRADLEY A PURCELL D.D.S. M.S. & RYAN M. MIZUMOTO D.M.D., M.S., INC
Doing business as
Spectrum Dental & Prosthodontics
Practice address
55 Caren Ave Ste 270
Worthington, OH 43085-2515
Phone
(614) 888-7012
Fax
(614) 888-0284
NPI assigned
Oct 25, 2012
Last updated
Nov 5, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Authorized official

Name
Bradley A Purcell, DDS, MSNPI 1073779575
Title
Owner/Dentist
Phone
(614) 885-4249

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 15174 MI Primary
Prosthodontics 1223P0700X 22655 IL

Addresses

Primary practice location

55 Caren Ave Ste 270
Worthington, OH 43085-2515

Mailing address

55 Caren Ave Ste 270
Worthington, OH 43085-2515
Phone (614) 888-7012

Other names 1

  • SPECTRUM DENTAL & PROSTHODONTICS Doing business as

National Provider Directory

National Provider Directory

Locations

55 Caren Ave
Ste 270
Worthington, OH 43085
Phone (614) 885-4401

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1912250135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CAREN AVE STE 270",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852515",
            "telephone_number": "614-888-7012",
            "fax_number": "614-888-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CAREN AVE STE 270",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430852515",
            "telephone_number": "614-888-7012",
            "fax_number": "614-888-0284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY A PURCELL D.D.S. M.S. & RYAN M. MIZUMOTO D.M.D., M.S., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-25",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "PURCELL",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "614-885-4249",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "15174",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "22655",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPECTRUM DENTAL & PROSTHODONTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.