MEDICARE: DR. BRADLEY DEVINE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	112087	CA

General Provider Information

NPI Number	:	1922857770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY DEVINE DDS

Provider Business Mailing Address
First Line	:	4003 PRIMAVERA RD
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93110-1467
Country	:	US
Telephone Number	:	805-448-0501
Fax Number	:

Provider Business Practice Location Address
First Line	:	5680 CALLE REAL
Second Line	:
City	:	GOLETA
State	:	CA
Zip	:	93117-2317
Country	:	US
Telephone Number	:	805-456-3063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2024
Last Update Date	:	05/08/2026

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