BRADLEY MORGAN JETTON (NPI# 1306115688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306115688 |
| Entity Type | Individual |
| Full Name | BRADLEY MORGAN JETTON |
| Credential | D.D.S |
| Practice Address |
4005 Broadway St Houston TX 77087-4703 |
| Practice Telephone | 7136444331 |
| Practice Fax Number | 7136441975 |
| Mailing Telephone | 7136444331 |
| Mailing Fax Number | 7136441975 |
| Enumeration Date | 2011-12-15 |
| Last Update Date | 2011-12-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 27218 | TX | Dental Providers |
| Street Address |
4005 BROADWAY ST |
| City | HOUSTON |
| State | TX |
| Zip Code | 77087-4703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902936966 | Jay Elliott D D S Pa | Dentist | 4005 Broadway St, Houston, TX 77087-4703 | 2007-03-07 |
| 1801349402 | Kyle Hale | Dentist | 4005 Broadway St, Houston, TX 77087-4703 | 2016-07-31 |
| 1356707087 | Jay Elliott Dds Pa | Dentist | 4005 Broadway St, Houston, TX 77087-4703 | 2016-01-11 |
| 1386026169 | Chelsea Jo Martin | Dentist | 4005 Broadway St, Houston, TX 77087-4703 | 2015-06-29 |
| 1134533797 | Kalli Elliott Hale | Dentist | 4005 Broadway St, Houston, TX 77087-4703 | 2014-06-11 |
| 1639502172 | Jay Edward Elliott | Dentist | 4005 Broadway St, Houston, TX 77087-4703 | 2013-08-20 |
| 1295050300 | Terry L Fisher | Dentist | 4005 Broadway St, Houston, TX 77087-4703 | 2010-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194350918 | Kirtan Patel | Student in an Organized Health Care Education/Training Program | 8447 Riverside Parkway, Bryan, TX 77087 | 2020-03-12 |
| 1902431232 | Jakelyn Esmeralda Alfaro | Family Medicine | 3420 Woodrridge Dr., Houston, TN 77087 | 2020-03-06 |
| 1518509827 | Paul Torres | Technician | 7002 Hemlock Apt. #1, Houston, TX 77087 | 2019-10-09 |
| 1841849254 | Shirley M Stredic | Technician | 6631 Reed Rd., Houston, TX 77087 | 2019-09-09 |
| 1376046342 | Priscilla Marie Williams | Personal Emergency Response Attendant | Mtss-priscilla: 5921 Northdale Rd Houtx 77087, Houston, TX 77087 | 2018-03-15 |
| 1639688187 | Ebony Iheanacho | Case Manager/Care Coordinator | 7011 Village Way #410, Houston, TX 77087 | 2017-09-27 |
| 1316300908 | Journey Through Life Tx LLC | Counselor | 7151 Office City Dr, Houston, TX 77087 | 2016-03-31 |
| 1528427531 | Katherine Winlin Tsai | Pharmacist | 3111 Woodridge, Ste. 500, Houston, TX 77087 | 2016-02-18 |
| 1134517428 | Gulfgate Kidney Center, LLC | Clinic/Center | 2916 Woodridge Dr, Houston, TX 77087 | 2015-01-08 |
| 1639577372 | Mann Eye2 20/20 Express | Optometrist | 2903 Woodbridge, Suite1290, Houston, TX 77087 | 2014-12-11 |
| Find all providers in zip 77087 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114525581 | Ashley Roy | Dentist | 9099 Katy Fwy Ste 180, Houston, TX 77024-1677 | 2020-10-16 |
| 1710592522 | Georgi Talmazov | Dentist | 8299 Cambridge St Apt 102, Houston, TX 77054-3138 | 2020-09-09 |
| 1982218673 | Marissa Fernandez | Dentist | 3527 Ozark St, Houston, TX 77021-1209 | 2020-09-01 |
| 1568075943 | Omar Fawzi Ismael | Dentist | 909 Dairy Ashford Rd Ste 109, Houston, TX 77079-5306 | 2020-08-26 |
| 1972115830 | Diana Dental Pllc | Dentist | 8619 Richmond Ave Ste 700, Houston, TX 77063-5688 | 2020-08-20 |
| 1861002388 | Safa Nawazish | Dentist | 9000 Almeda Rd Apt 9107, Houston, TX 77054-4341 | 2020-08-10 |
| 1568088524 | Smile Squad of Houston Shepherd Pllc | Dentist | 3800 N Shepherd Dr Ste 3-a, Houston, TX 77018-6400 | 2020-06-24 |
| 1063037646 | Veterans Dental Center | Dentist | 10403 Lark Rdg, Houston, TX 77070-4875 | 2020-06-10 |
| 1841814738 | Texas Dental Associates, Pa | Dentist | 5230 Buffalo Speedway, Houston, TX 77005-4204 | 2020-06-05 |
| 1750910659 | Ph Dentistry, PC | Dentist | 17619 Fm 529 Rd, Houston, TX 77095-1003 | 2020-04-03 |
| Find all providers in HOUSTON | ||||
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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.