BRADLEY DENTAL (NPI# 1770848129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770848129 |
| Entity Type | Organization |
| Organization Name | BRADLEY DENTAL |
| Practice Address |
21635 Ryan Rd Warren MI 48091-2788 |
| Practice Telephone | 5867577540 |
| Mailing Telephone | 5867577540 |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2014-09-09 |
| Authorized Official Name | DANA HORSCH (MANAGER) |
| Authorized Official Telephone | 5867577540 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
2451596 | MI | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
MI | Dental Providers | |
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
15917 | MI | Suppliers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
15917 | MI | Dental Providers |
| Street Address |
21635 RYAN RD |
| City | WARREN |
| State | MI |
| Zip Code | 48091-2788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801345061 | Great Lakes Family Dental Group-warren, P.C. | Dentist | 21635 Ryan Rd, Warren, MI 48091-2788 | 2016-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548615172 | Amanda Lynn Kelsey | Nurse Practitioner | 21647 Ryan Road, Warren, MI 48091 | 2016-05-02 |
| 1902284474 | Daejana Maldonado | Licensed Practical Nurse | 7519 Toepfer, Warren, MI 48091 | 2015-05-15 |
| 1245637743 | Jerami Roy | Recreation Therapist | 7086 E 9 Mile, Warren, MI 48091 | 2014-11-26 |
| 1265698344 | Amanda Sarah Yousif-mansour | Dentist | 2442 E 10 Mile Road, Warren, MI 48091 | 2008-07-29 |
| 1326171166 | Sunshine Dental Center PC | Dentist | 21761 Ryan Rd, Warren, MI 48091 | 2007-03-13 |
| 1487709630 | Albert Spickers | General Practice | 26193 Meredith Drive, Warren, MI 48091 | 2007-01-25 |
| 1487706859 | Rita Jean Rose | Physician Assistant | 2104 E. 11 Mile Road, Suite 600, Warren, MI 48091 | 2007-01-17 |
| 1790835452 | Cole Vision Corporation | Eyewear Supplier (Equipment, not the service) | 2000 Ten Mile Rd., Warren, MI 48091 | 2007-01-12 |
| 1942363759 | Carolyn Joan Sucaet | Physical Therapist | 20952 12 Mile Road, Suite 110, St. Clair Shores, FM 48091 | 2006-12-19 |
| 1013070135 | Mcnichols Xray Clinic PC | Radiology | 21230 Dequindre Road, Southeast Michigan Surgical Hospital, Warren, MI 48091 | 2006-12-19 |
| Find all providers in zip 48091 | ||||
| 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 |
|---|---|---|---|---|
| 1578177713 | Warren Family Dentistry | Dentist | 11250 E 13 Mile Rd Ste 3, Warren, MI 48093-2597 | 2020-09-04 |
| 1144847294 | Rezan Doku | Dentist | 11552 E 12 Mile Rd Ste 105, Warren, MI 48093-2644 | 2020-07-06 |
| 1710449459 | Benjamin J Underwood Dds LLC | Dentist | 6213 Chicago Rd Ste 100, Warren, MI 48092-1697 | 2019-04-02 |
| 1902341233 | George C. Ploumbis, Dds, Inc. | Dentist | 2239 E Market St, Warren, OH 44483-6105 | 2016-12-22 |
| 1023491586 | A1 Family Dentistry,plc | Dentist | 30205 Schoenherr Rd Ste E, Warren, MI 48088-6800 | 2015-07-02 |
| 1013250026 | Warren Dental Group, David M Raiffe, Dds, Mba, Inc | Dentist | 1019 N Park Ave, Warren, OH 44483-3725 | 2013-03-28 |
| 1508124363 | Marek Jaroslaw Ogledzki | Dentist | 11900 E 12 Mile Rd Ste 210, Warren, MI 48093-3490 | 2012-04-30 |
| 1558636936 | Soft Care Dental Group | Dentist | 108 Town Center Dr, Warren, NJ 07059-5692 | 2012-03-18 |
| 1487884375 | Thomas Joseph Wilson | Dentist | 8401 Howland Springs Rd Se, Warren, OH 44484-3120 | 2009-07-26 |
| 1801054085 | Oleg Doubrovski | Dentist | 4265 E 10 Mile Rd, Warren, MI 48091-1578 | 2008-05-24 |
| Find all providers in WARREN | ||||
Please comment or provide details below to improve the information on BRADLEY DENTAL.
| 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.