Brad N Judy, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60067325 Issued in WA

Practice address

3236 78TH Ave SE Ste 106
Mercer Island, WA 98040-3500

Phone

(206) 232-5866

Fax

(206) 232-5870

NPI assigned

Jan 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Emergency Dental Care USA

  • General Practice Dentistry
  • Seattle, WA
  • NPI 1073748125
  NPD (past)
• John C Lind DDS

  • General Practice Dentistry
  • Mercer Island, WA
  • NPI 1003927245
  NPD (past)

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1922154335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8980 SE 54TH ST",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980405143",
            "telephone_number": "206-612-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3236 78TH AVE SE STE 106",
            "city": "MERCER ISLAND",
            "state": "WA",
            "postal_code": "980403500",
            "telephone_number": "206-232-5866",
            "fax_number": "206-232-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUDY",
        "first_name": "BRAD",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60067325",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60067325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DENTAL LICENSE",
            "identifier": "WA 60067325",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael Cottrell Johnson
• Ray Johnson
• Therese Ann Johnson, LMHC
• Jolly Way Health Inc., P.S. Dba Mercer Wellness
• Taryn Anne Jones, MS, RDN, CD
• Parisa Kabiri, PHARMACIST
• Allene Kaplan, M.A., L.M.F.T.
• Kara McCulloch DMD MSD PLLC
• Renee S. Katz, PHD
• Daniel L. Kent, M.D.

• General Practice Dentistry in Mercer Island, WA
• Providers in Mercer Island, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.