Bradford L Picot, DDS, P.A.
Dentist, General Practice in Charlotte, NC. Organization (NPI-2).
Details
- NPI
- 1003048752
- Entity type
- Organization (NPI-2)
- Legal business name
- Bradford L Picot, DDS, P.A.
- Organization subpart
- No
- Enumeration date
- Aug 13, 2009
- Last updated
- Aug 13, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 8158 | NC | Yes |
| 302R00000X | Health Maintenance Organization | 8158 | NC |
Other names
- Southend Dentistry (Doing Business As)
Practice location
1520 South BlvdSuite 110
Charlotte, NC 28203-4786
Phone 704-335-8266 · Fax 704-335-8267
Mailing address
1520 South BlvdSuite 110
Charlotte, NC 28203-4786
Phone 704-335-8266 · Fax 704-335-8267
Authorized official
Bradford Lee Picot
Owner/Dentist
7043358266
Is something wrong?
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