Active NPI
Bradley John Aebi, DMD
- Oral and Maxillofacial Surgery (Dentist)
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- D8302
- Practice address
- Landstuhl Regional Medical Center
CMR 402 Unit 33301
Apo, AE 09180 - Phone
- (314) 590-7883
- NPI assigned
- Oct 16, 2006
- Last updated
- Jul 9, 2025
- 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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | D8302 | OR | Primary |
Addresses
Primary practice location
Landstuhl Regional Medical Center
CMR 402 Unit 33301
Apo, AE 09180
Mailing address
PO Box 3777
Portland, OR 97208-3777
Phone (503) 413-3714
Other practice location 1
300 N Graham St Ste 125
Portland, OR 97227
Phone (503) 413-3714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D8302 | OR | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Clinics LLC | Current | Accepting new patients |
Locations
1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134
1919 NW Lovejoy St
Portland, OR 97209
Phone (503) 415-5600
300 N Graham St
Ste 125
Portland, OR 97227
Phone (503) 413-3714
Interoperability endpoints
- baebi827394@ahs.direct-ci.com
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- Portland, OR
- NPI 1902827272
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752019200000",
"number": "1942380761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3777",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972083777",
"telephone_number": "503-413-3714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "MIL",
"address_1": "LANDSTUHL REGIONAL MEDICAL CENTER",
"address_2": "CMR 402 UNIT 33301",
"city": "APO",
"state": "AE",
"postal_code": "09180",
"telephone_number": "314-590-7883"
}
],
"practiceLocations": [
{
"address_1": "300 N Graham St Ste 125",
"address_purpose": "LOCATION",
"city": "Portland",
"state": "OR",
"postal_code": "97227",
"country_code": "US",
"telephone_number": "503-413-3714",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AEBI",
"first_name": "BRADLEY",
"middle_name": "JOHN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-16",
"last_updated": "2025-07-09",
"certification_date": "2025-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "OR",
"license": "D8302",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.