Bradley Girdwood
Dentist, General Practice in Cincinnati, OH. Individual provider (NPI-1).
NPI number1043771900
StatusActive
Last updated in NPPESFeb 26, 2021
Details
- NPI
- 1043771900
- Entity type
- Individual (NPI-1)
- Name
- Bradley Girdwood
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 25, 2019
- Certification date
- Feb 26, 2021
- Last updated
- Feb 26, 2021
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 | 30026284 | OH | Yes |
Practice location
4030 Smith Rd Ste 110Cincinnati, OH 45209-1937
Phone 513-631-8920
Mailing address
100 Rough Way Unit 10Lebanon, OH 45036-7914
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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