MRS. LYNNETTE BRADLEY (NPI# 1033753298) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033753298 |
| Entity Type | Individual |
| Full Name | MRS. LYNNETTE BRADLEY |
| Practice Address |
4218 Giles Ct Riverside CA 92503-3154 |
| Mailing Address |
Po Box 7512 Riverside CA 92513-7512 |
| Practice Telephone | 9513145349 |
| Mailing Telephone | 9513145349 |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2019-10-31 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125K00000X | Advanced Practice Dental Therapist | HAP754 | CA | Dental Providers |
| Street Address |
4218 GILES CT |
| City | RIVERSIDE |
| State | CA |
| Zip Code | 92503-3154 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255953618 | Mohammad Abul-fielat Dds Inc | Dentist | 3825 Tyler St, Riverside, CA 92503 | 2020-05-08 |
| 1205396488 | Francisco Aguayo | Behavioral Analyst | 3345 Jackson St, Riverside, CA 92503 | 2019-03-22 |
| 1073071684 | Racheal Ego Aneke | Nurse Practitioner | 9890 County Farm Rd., Building 2, Riverside, CA 92503 | 2019-03-04 |
| 1073070264 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 3500 Tyler Mall, Riverside, CA 92503 | 2019-02-25 |
| 1053893271 | Tsibel Dental Practice Inc. | Dentist | 10181 Magnolia Ave, Riverside, CA 92503 | 2018-09-04 |
| 1508344714 | Patricia Marraine Redondo | Counselor | 1625 14th St, Riverside, CA 92503 | 2018-07-31 |
| 1740766146 | Robles Rodef & Yaghoubi Dental Corporation | Dentist | 5628 Van Buren Blvd Suite #a, Riverside, CA 92503 | 2018-07-18 |
| 1467961755 | Daniela Popa | Assisted Living Facility | 10820 Calle Bella, Riverside, CA 92503 | 2017-09-29 |
| 1457860306 | Leah Dreany | Peer Specialist | 2085 Rustin Avenue Building #3, Riverside, CA 92503 | 2017-09-22 |
| 1710400445 | Christopher John Guting | Peer Specialist | 10230 Indiana Avenue, Riverside, CA 92503 | 2017-07-25 |
| Find all providers in zip 92503 | ||||
| Taxonomy Code | 125K00000X |
| Grouping | Dental Providers |
| Classification | Advanced Practice Dental Therapist |
| An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922484682 | Travis Tramel | Advanced Practice Dental Therapist | 4199 Flat Rock Dr, Suite 127, Riverside, CA 92505-7115 | 2015-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538760459 | Carlos Heriberto Quinonez | Advanced Practice Dental Therapist | 16077 Chella Dr, Hacienda Heights, CA 91745-6402 | 2020-11-06 |
| 1598314023 | Peter Korn | Advanced Practice Dental Therapist | 11135 Rosemary Dr, Auburn, CA 95603-5945 | 2019-09-06 |
| 1154982395 | Evelyn Marie Schrager | Advanced Practice Dental Therapist | 803 E Woodhaven Ln, Fresno, CA 93720-1209 | 2019-06-27 |
| 1558828160 | Charon Moody | Advanced Practice Dental Therapist | 727 E Holborn Dr, Carson, CA 90746-2328 | 2019-03-01 |
| 1104371368 | Marie Ekins Rdhap Corp | Advanced Practice Dental Therapist | 10831 Canelo Rd, Whittier, CA 90604-1902 | 2016-08-17 |
| 1851774186 | Terri De La Pena | Advanced Practice Dental Therapist | 10011 Shaggybark Dr, Santee, CA 92071-1136 | 2015-07-06 |
| 1720470230 | Christine Jackson-bartolomei | Advanced Practice Dental Therapist | 4806 Darlington Ln, Sacramento, CA 95835-2000 | 2015-02-21 |
| 1356753826 | Megan Ellen Graff | Advanced Practice Dental Therapist | 6084 Gold Spirit St, Eastvale, CA 92880-0988 | 2014-06-02 |
| 1275958597 | Theresa Zenner Clouse | Advanced Practice Dental Therapist | 1849 S Tamarack St, Visalia, CA 93277-8422 | 2014-02-24 |
| 1689002925 | Nooshin Basseri | Advanced Practice Dental Therapist | 3140 Melendy Drive, San Carlos, CA 94070 | 2013-10-24 |
| Find all providers with the same taxonomy | ||||
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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.