DR. JERRY E. BRADLEY


Address: 1225 Breckenridge Drive, Suite 110, Little Rock, AR 72205
Phone: 5012254644

DR. JERRY E. BRADLEY (NPI# 1295862357) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1295862357
Entity Type Individual
Full Name DR. JERRY E. BRADLEY
Credential DMD
Practice Address 1225 Breckenridge Drive
Suite 110
Little Rock
AR 72205
Mailing Address 1225 Breckenridge Dr
Suite 110
Little Rock
AR 72205-1558
Practice Telephone 5012254644
Practice Fax Number 5012254102
Mailing Telephone 5012254644
Mailing Fax Number 5012254102
Enumeration Date 2007-02-27
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223P0300X Dentist
Specialization: Periodontics
12 AR Dental Providers

Other Providers JERRY BRADLEY

NPI Name Taxonomy Address Enumeration
1184713505 Jerry L Bradley Dentist 512 Coke Avenue, Edenton, NC 27932 2006-10-12
1376882563 Jerry Allen Bradley Jr. Family Medicine 811 E Parrish Ave, Owensboro, KY 42303-3258 2013-02-07
1558303644 Jerry Wayne Bradley Emergency Medicine 709 Middle Creek Rd, Sevierville, TN 37862-5047 2006-06-12

Office Location

Street Address 1225 BRECKENRIDGE DRIVE
SUITE 110
City LITTLE ROCK
State AR
Zip Code 72205

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1932719465 Darleisha Renee Stigall Behavior Technician 1210 Aldersdate Rd, Little Rock, AR 72205 2020-08-10
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1225667272 Ann-marie Frances Hayre Student in an Organized Health Care Education/Training Program 4310 West Markham, Slot 589, Little Rock, AR 72205 2020-04-02
1952930075 Alexandria Leigh Smith Student in an Organized Health Care Education/Training Program 4301 West Markham St, Slot 531, Little Rock, AR 72205 2020-04-02
1093353922 Phil Fagala Pharmacist 614 North Beechwood, Little Rock, AR 72205 2019-12-10
1295391688 Home To Community Living, Inc Physical Therapist 10201 W Markham Street Pulaski, Little Rock, AR 72205 2019-05-12
1669933693 Sandy Louise Webb Student in an Organized Health Care Education/Training Program 4301 West Markham, Slot 530, Little Rock, AR 72205 2019-03-31
1457812828 Vincent Battafarano Student in an Organized Health Care Education/Training Program 4301 West Markham, Slot 602, Little Rock, AR 72205 2019-03-28
1063978922 Franks Pediatric Occupational Therapy LLC Occupational Therapist 5516 C St, Little Rock, AR 72205 2019-02-15
1497210199 Integrative Counseling Center LLC Counselor 10515 W Markham St Ste D3, Little Rock, AR 72205 2019-02-06
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Taxonomy Information

Taxonomy Code 1223P0300X
Grouping Dental Providers
Classification Dentist
Specialization Periodontics

Taxonomy Definition

That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1336163542 Donald Paul Callan Dentist 10319 W. Markham St., Suite 300, Little Rock, AR 72205-4556 2006-07-27
1568442788 John Edward Svendsen Dentist 16101 Lagrande Dr, Suite 101, Little Rock, AR 72223-9140 2006-01-23
1396189270 Pinnacle Periodontics Dentist 1225 Breckenridge Dr, #110, Little Rock, AR 72205-1558 2013-04-23
1821001637 Drs. Woodard & Sundell, Dds, Pa Dentist 11300 Cantrell Rd Ste 303, Little Rock, AR 72212-1844 2006-08-14
1689687584 Tacy Marie Sundell Dentist 11300 Cantrell Rd Ste 303, Little Rock, AR 72212-1844 2006-08-14
1306853775 John Robert Spray Dentist 4815 W Markham St, Slot 33, Little Rock, AR 72205-3866 2006-08-01
1134134703 Marny L Lemons-prince Dentist 1225 Breckenridge Dr, Suite 210, Little Rock, AR 72205-1558 2006-07-30
1265446165 Arkansas Periodontal Associates Dentist 10319 W. Markham St., Suite 300, Little Rock, AR 72205-4556 2006-07-28
1548202856 Lloyd F. Church Jr. Dentist 10310 W Markham St, Suite 301, Little Rock, AR 72205-2175 2006-06-12

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1154793982 White & Blansett Periodontics & Dental Implants Dentist 201 N 34th St, Rogers, AR 72756-0352 2015-10-20
1790819233 Ronald Howell Follis Dentist 800 W B St, Russellville, AR 72801-3610 2007-03-15
1407907165 Peder J Jensen Dentist 2501 Crestwood Rd Ste 102, North Little Rock, AR 72116-7615 2007-01-16
1154496297 Charles Adrian White Dentist 201 N 34th, Rogers, AR 72756 2006-11-22
1780772962 Michael L. Thompson Dentist 2737 Paula Dr, Jonesboro, AR 72404-8017 2006-10-11
1497852495 Michael Curry Dentist 1831 N Green Acres Rd, Fayetteville, AR 72703-2615 2006-09-20
1225134828 Charles J. Antonini, Dds, Ms Dentist 200 Mcauley Ct, Hot Springs, AR 71913-6312 2006-09-15
1497762090 Harry Hoffman Morgan Dentist 3800 Rogers Ave Ste 3, Fort Smith, AR 72903-3074 2006-08-03
1689626269 Stephen A Rappeport Dentist 304 N Greenwood Ave, Fort Smith, AR 72901-3454 2006-05-16
1295730562 D. Ross Atkinson Dentist 2633 Malvern Ave, Hot Springs, AR 71901-8176 2005-06-14
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Competitor

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City LITTLE ROCK
Zip Code 72205

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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