Destiny Bradley

Primary specialty

DentistTaxonomy code 122300000X

License

14158 Issued in CT

Practice address

434 S Bridge St Ste B
Auburn, MA 01501-4423

Phone

(508) 752-6649

NPI assigned

Mar 6, 2023

Last updated

Jul 10, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Jasmin Henville DMD - Libson PC

  dba Aspen Dental

  • General Practice Dentistry
  • Lisbon, CT
  • NPI 1912350299
  NPD (past)

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1942900246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 FALES ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062021",
            "telephone_number": "774-262-2923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 S BRIDGE ST STE B",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015014423",
            "telephone_number": "508-752-6649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "193 River Rd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Lisbon",
            "state": "CT",
            "postal_code": "063513258",
            "country_code": "US",
            "telephone_number": "860-376-8800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRADLEY",
        "first_name": "DESTINY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-06",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "14158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert M. Bogdasarian, PA-C
• Laurie A Borriello, PT
• Doreen Quiry Bove, MS C.C.C. SLP
• William John Bowes, MSC LSW
• Corinne Nicolle Boyd
• Carla Marie Brady, SLP
• Marc L Braithwaite, O.D.
• Richard Allan Bream, MD
• Clare Breen, NP
• Nicole Brodie

• Dentist in Auburn, MA
• Providers in Auburn, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.