Healthcare Provider Details

I. General information

NPI: 1801730445
Provider Name (Legal Business Name): BRADY DENTAL GROUP OF TAMPA BAY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26907 FOGGY CREEK RD STE 101
WESLEY CHAPEL FL
33544-6778
US

IV. Provider business mailing address

PO BOX 50006
DENTON TX
76206-0006
US

V. Phone/Fax

Practice location:
  • Phone: 844-409-4657
  • Fax: 214-614-4277
Mailing address:
  • Phone: 844-409-4657
  • Fax: 214-614-4277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. ANGIE NAUMAN
Title or Position: DENTAL DIRECTOR
Credential: DDS
Phone: 844-409-4657