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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223P0300X |
Dentist Specialization: Periodontics |
12 | AR | Dental Providers |
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 |
Street Address |
1225 BRECKENRIDGE DRIVE SUITE 110 |
City | LITTLE ROCK |
State | AR |
Zip Code | 72205 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932719465 | Darleisha Renee Stigall | Behavior Technician | 1210 Aldersdate Rd, Little Rock, AR 72205 | 2020-08-10 |
1316563638 | Unknown Amisha | Student in an Organized Health Care Education/Training Program | 4301 West Markham St, Slot #634, University of Arkansas, Little Rock, AR 72205 | 2020-06-23 |
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 |
Find all providers in zip 72205 |
Taxonomy Code | 1223P0300X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Periodontics |
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 |
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 |
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 |
Find all providers with the same taxonomy |
City | LITTLE ROCK |
Zip Code | 72205 |
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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.