Bradley Olin Adams, D.M.D.
Individual provider Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Valdosta, GA
NPI 1922026111 · NPPES record last updated Aug 29, 2023
Key facts
- NPI
- 1922026111
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
- License
- 11523 (GA)
- Practice address
- 816 Northwood Park Drive
Valdosta, GA 31602 - Phone
- (229) 247-6960
- Fax
- (229) 247-8870
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11523 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
| DN011532 | GA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DN011532 | GA | |
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 11523 | GA | Yes |
Addresses
Primary practice location
816 Northwood Park Drive
Valdosta, GA 31602
Mailing address
816 Northwood Park Drive
Valdosta, GA 31602
Phone (229) 247-6960
Other providers in Valdosta, GA
- Abundantly Above All Primary Care
- Activear, LLC
- Acute Dialysis
- Acute Rehab Equipment Inc
- Simon Adames
- Carter Adams
- Cornelia Adams
- Debra Ann Adams
- Joan Adams
- Katharine Susan Adams
All providers in Valdosta, GA · Orthodontics and Dentofacial Orthopedics Dentistry in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.