Active NPI
Bradley Merritt, DDS
- Dentist
- Berkley, MI
National Provider Identifier
1992359566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901600202
- Practice address
- 1865 Coolidge Hwy
Berkley, MI 48072-3042 - Phone
- (248) 398-5050
- NPI assigned
- Jul 31, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2901600202 | MI | |
| Dentist | 122300000X | 2901600202 | MI | Primary |
Addresses
Primary practice location
1865 Coolidge Hwy
Berkley, MI 48072-3042
Mailing address
7300 Old Mill Rd
Bloomfield Hills, MI 48301-3936
Phone (248) 719-3384
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901600202 | MI | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1564531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594684800000",
"number": "1992359566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7300 OLD MILL RD",
"city": "BLOOMFIELD HILLS",
"state": "MI",
"postal_code": "483013936",
"telephone_number": "248-719-3384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1865 COOLIDGE HWY",
"city": "BERKLEY",
"state": "MI",
"postal_code": "480723042",
"telephone_number": "248-398-5050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "BRADLEY",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-31",
"last_updated": "2020-07-14",
"certification_date": "2020-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2901600202",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901600202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berkley, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.