David A Bradley, DDS
Individual provider Active NPI General Practice Dentistry · Adamsville, TN
NPI 1962541789 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962541789
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DS4159 (TN)
- Practice address
- 349 East Main Street
Adamsville, TN 38310-0260 - Phone
- (731) 632-1680
- Fax
- (731) 632-1680
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150709002801 | TN | Order and Referring Only - Oral Surgery |
9931411584 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS4159 | TN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| David Bradley DDS Inc. | General Practice | Past |
Accepting new patients |
| Bradley Family Dentistry Inc | General Practice | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS4159 | TN | Yes |
Addresses
Primary practice location
349 East Main Street
Adamsville, TN 38310-0260
Mailing address
PO Box 260
Adamsville, TN 38310-0260
Phone (731) 632-1680
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 641378 | Other | PA | UNITED CONCORDIA |
| 0107857 | Other | TN | BLUE CROSS BLUE SHIELD |
Other providers in Adamsville, TN
- Blossoming Behavioral Solutions LLC
- Emily Rush Boatwright
- Ashley Booth
- Bradley Family Dentistry Inc
- Allison Jack Bradley
- Maxwell Bradley
- Sherri Brown
- Anna Carroll
- Compass Therapy Services
- Compass Therapy Services
All providers in Adamsville, TN · General Practice Dentistry in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.