DR. MARILYN EUGENIA BRADDOCK (NPI# 1245205863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245205863 |
| Entity Type | Individual |
| Full Name | DR. MARILYN EUGENIA BRADDOCK |
| Credential | DDS, MS, MHA |
| Practice Address |
Uss George Washington Cvn 73 Dental Dept., Box 66 Fpo AE 09550-2873 |
| Mailing Address |
5311 Spy Glass Dr Norfolk VA 23518-6305 |
| Practice Telephone | 7579624537 |
| Mailing Telephone | 7579624537 |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2008-04-20 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0700X |
Dentist Specialization: Prosthodontics |
0401006086 | VA | Dental Providers |
| Street Address |
USS GEORGE WASHINGTON CVN 73 DENTAL DEPT. , BOX 66 |
| City | FPO |
| State | AE |
| Zip Code | 09550-2873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295709079 | Christopher John Maldarella | Physician Assistant | Uss George Washington Cvn 73, Fpo, VA 09550-2873 | 2006-02-16 |
| 1902049463 | Timothy Michael Bickerton | Military Health Care Provider | Uss George Washington Cvn 73, Fpo, AP 96650-2801 | 2009-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215142195 | Sonya Annette Hendrix | Military Health Care Provider | Uss George Washington Cvn-73, Medical Department, Fpo, AE 09550 | 2007-05-13 |
| 1346314739 | Shannon Renee Blackmer | Preventive Medicine | Uss George Washington, Fpo, AE 09550-2801 | 2006-11-20 |
| 1609814995 | Weston Rayth Wright | Military Health Care Provider | Uss George Washington Cvn-73, Box 67, Fpo, AE 09550-2873 | 2006-06-02 |
| 1750361069 | James Calvin Young | Family Medicine | Cvn 73 Box 67, Fpo, AE 09550-2873 | 2006-01-20 |
| 1376523365 | Donald Alan Lonergan | Dentist | Uss Washington, Dental - Box 66, Fpo, AE 09550-2873 | 2006-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841899853 | London Mingo | Social Worker | 2769 Yaka Kin Cho, Fpo, AP 96388-0071 | 2020-10-21 |
| 1538768833 | James Blake Weldon | Military Health Care Provider | Unit 100517 Bx 1, Fpo, AP 09655 | 2020-10-19 |
| 1487260311 | Doria Living | Registered Nurse | Ushno, Fpo, AP 96367 | 2020-09-16 |
| 1225643307 | Brice Blahnik | Dentist | 1 St Dental Battalion/naval Dental Center Attn: Medical, Bldg 2238 A Ave Camp Pendleton, Ca. 92055-5221, Fpo, AA 92055-5221 | 2020-09-15 |
| 1609489061 | Genesis Health Care Inc | Home Health | Uss Wasp Lhd1 Unit 100261, Fpo, AE 09514 | 2020-08-26 |
| 1669081857 | Acacia L Elmer | Registered Nurse | Psc 808 Box 3104, Fpo, AE 09618-0032 | 2020-07-24 |
| 1932724754 | William Dowling | Student in an Organized Health Care Education/Training Program | 260 John Paul Jones Circle, Fpo, AA 23708 | 2020-06-09 |
| 1518581776 | Taylor D Benson | Audiologist | Building 960, Floor 3, East Wing, Fpo, AP 96362-0017 | 2020-06-03 |
| 1740803279 | Issa Khalil | Military Health Care Provider | Uss Donald Cook, Fpo, AE 09566 | 2020-05-19 |
| 1295360055 | Kiran Kumar Gurung | Dental Hygienist | Uss Bataan (lhd-5), Fpo, AE 09554-1657 | 2020-03-11 |
| Find all providers in FPO | ||||
| Taxonomy Code | 1223P0700X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Prosthodontics |
| That branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497132393 | Diane Vo | Dentist | 3d Den Bn 3mlg Det H, Unit 38452 Box 259, Fpo, AP 96385 | 2015-04-29 |
| 1629321278 | Christopher David Dindal | Dentist | Psc 558 Box 4177, Fpo, AP 96375-4100 | 2012-10-19 |
| 1376523365 | Donald Alan Lonergan | Dentist | Uss Washington, Dental - Box 66, Fpo, AE 09550-2873 | 2006-01-18 |
| 1740267517 | Michael Roderick Brenyo | Dentist | Psc 557, Box 1207, Fpo, AP 96379-1207 | 2005-12-22 |
| 1356341580 | Francisco Xavier Veray Iv | Dentist | Psc 827 Box526, Fpo, GRICIGNANO AE | 2005-07-29 |
| 1730184771 | Johvin Perry | Dentist | U.S. Naval Hospital Yokosuka, Psc 475 Box 1, Fpo, AP 96350-9998 | 2005-06-16 |
| 1558347435 | Peter Barndt | Dentist | Us Naval Hospital Yokosuka, Fpo, AP 96350 | 2005-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326013616 | Julio Gonzales | Dentist | Cdr Us Army Dental Activity, Cmr 489 Box 2604, Apo, AE 09128 | 2006-02-21 |
| 1023075231 | Minaxi I Patel | Dentist | Unit 26610, Wuerzburg Dental Activity Credentials Office, Apo, AE 09244 | 2006-05-01 |
| 1346238102 | David F Pierson | Dentist | Unit 5210, Box 230, Apo, AE 09461 | 2005-10-06 |
| 1164419016 | Jose Dejesus Villalobos | Dentist | 435 Mdg, Unit 3215, Apo, AE 09094 | 2005-10-05 |
| 1124015383 | Paul Edward Schleier | Dentist | 435 Mdg, Unit 3215, Apo, AE 09094 | 2005-10-04 |
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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.