DR. BRADLEY ROBERTSON (NPI# 1568580074) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568580074 |
| Entity Type | Individual |
| Full Name | DR. BRADLEY ROBERTSON |
| Credential | D.D.S |
| Practice Address |
1212 N Cole Rd Boise ID 83704-8646 |
| Mailing Address |
2957 W Colony Ct Eagle ID 83616-7201 |
| Practice Telephone | 2083221747 |
| Practice Fax Number | 2083221748 |
| Mailing Telephone | 2089383520 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D3022 | ID | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ID | UNITED CONCORDIA ID # | 834079 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760425326 | Bradley Robertson | Emergency Medicine | 1809 Capital Dr, Tyler, TX 75701-8438 | 2006-06-13 |
| 1336151109 | Bradley Charles Robertson | Surgery | 1 Barrington Pl, Bel Air, MD 21014-5607 | 2006-08-12 |
| Street Address |
1212 N COLE RD |
| City | BOISE |
| State | ID |
| Zip Code | 83704-8646 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710057211 | Trotter Vaughan | Dentist | 1212 N Cole Rd, Boise, ID 83704-8646 | 2006-11-09 |
| 1639699036 | Leslie A Wagner | Dentist | 1212 N Cole Rd, Boise, ID 83704-8646 | 2017-06-27 |
| 1346634870 | Hd Boise Dental, LLC | Dentist | 1212 N Cole Rd, Boise, ID 83704-8646 | 2015-03-23 |
| 1881039709 | Blanchard Dds PC | Clinic/Center | 1212 N Cole Rd, Boise, ID 83704-8646 | 2013-05-06 |
| 1710164793 | Art Dental | Dentist | 1212 N Cole Rd, Boise, ID 83704-8646 | 2008-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215535893 | Laura Diggs | Counselor | 400 North Benjamin Lane, Suite 200, Boise, ID 83704 | 2020-10-15 |
| 1891304002 | Tree City Family Dental | Dentist | 7301 W. Emerald St Ste. 102, Boise, ID 83704 | 2020-07-24 |
| 1982230710 | Jessica Wynn Councell | Midwife | 1072 N Liberty St Ste 100, Boise, ID 83704 | 2020-03-12 |
| 1699307124 | Isabel Burns Bruce | Registered Nurse | 777 N Raymond Street, Boise, ID 83704 | 2020-02-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1053960286 | Kyle Hiromi Hatanaka | Acupuncturist | 9450 #120 Fairview Avenue, Boise, ID 83704 | 2019-09-10 |
| 1700447141 | Katie Elizabeth Nichols | Physician Assistant | 1072 N Liberty St Ste 201, Boise, ID 83704 | 2019-06-26 |
| 1588164727 | Cory Michael Sims | Counselor | 6550 W. Emerald St #112, Boise, ID 83704 | 2018-02-14 |
| 1477072270 | Matthew Lee Love | Non-emergency Medical Transport (VAN) | 6933 W. Stratton St, Boise, ID 83704 | 2017-09-12 |
| 1942735949 | Dalana Sue Thompson | Counselor | 9196 Emerald St Suite #130, Boise, ID 83704 | 2017-04-27 |
| Find all providers in zip 83704 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588273635 | Atlantis Dental Care, P.a. | Dentist | 13238 W Persimmon Ln Ste 100, Boise, ID 83713-1968 | 2020-07-24 |
| 1235747338 | Dentists of Boise and Orthodontics, PC | Dentist | 7500 W State St Ste 110, Boise, ID 83714-6074 | 2020-07-15 |
| 1346895232 | Tejasi Avasare | Dentist | 8321 W Overland Rd, Boise, ID 83709-1640 | 2019-08-07 |
| 1528610359 | Melissa Marie Pysnak | Dentist | 8850 W Emerald St Ste 150, Boise, ID 83704-4809 | 2019-07-11 |
| 1124684584 | Trevor Tafoya Dds Victory Dental, Pllc | Dentist | 7421 W Victory Rd, Boise, ID 83709-5106 | 2019-05-11 |
| 1982260360 | Brant Burbank | Dentist | 4255 N Eagle Rd Ste 102, Boise, ID 83713-0701 | 2019-05-11 |
| 1972023398 | Northview Dental Partnership LLC | Dentist | 7480 W Northview St, Boise, ID 83704-7232 | 2017-06-27 |
| 1962939421 | Travis Jon Weimer | Dentist | 8336 W Northview St, Boise, ID 83704-7132 | 2017-05-16 |
| 1922480284 | Jonathan W Pluid | Dentist | 4274 N Eagle Rd, Boise, ID 83713-0726 | 2015-06-23 |
| 1922489673 | Gray Team LLC | Dentist | 813 N Stilson Rd, Ste:b, Boise, ID 83703-5119 | 2015-06-17 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on DR. BRADLEY ROBERTSON.
| 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.