Rudolph John Braydich Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30015561 Issued in OH

Practice address

45 E Liberty St
Hubbard, OH 44425-2160

Phone

(330) 534-5408

Fax

(330) 534-5490

NPI assigned

Apr 18, 2006

Last updated

Jul 9, 2013By the provider in NPPES

Sex

Male

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• Braydich Center for Advanced Dentistry

  • General Practice Dentistry
  • Hubbard, OH
  • NPI 1750548913
  Authorized official Same address or phone
• Braydich Dental Inc

  • General Practice Dentistry
  • Hubbard, OH
  • NPI 1184044604
  NPD (past) Authorized official

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1992760789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 E LIBERTY ST",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444252160",
            "telephone_number": "330-534-5408",
            "fax_number": "330-534-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 E LIBERTY ST",
            "city": "HUBBARD",
            "state": "OH",
            "postal_code": "444252160",
            "telephone_number": "330-534-5408",
            "fax_number": "330-534-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAYDICH",
        "first_name": "RUDOLPH",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30015561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Bottar, D.O.
• Danna Bozick, LSW, NCC, LICDC, CTT
• Braydich Center for Advanced Dentistry
• Braydich Dental Inc
• Mark Peter Braydich, DDS
• Dana Kristine Brown, MS, CCC-SLP
• Stephanie M Burnett, LPT
• Gregory Alan Burrows, D.O.
• Linda A Byers
• Yuliya Byshenko

• General Practice Dentistry in Hubbard, OH
• Providers in Hubbard, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.

Verify at the official NPI Registry.