Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Zackary Michael Bradshaw, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1750076063

Zackary Michael Bradshaw, DDS is a Student in an Organized Health Care Education/Training Program in Augusta, Georgia. Practices as a sole proprietor. Licensed in Georgia.

Licensed in
GA
In the registry since
2023
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

1120 15th St # GC5110
Augusta, GA 30912-0004
Phone: (706) 721-2371
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X · Licence DN123617 (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1750076063
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedApril 11, 2023
Last updated in NPPESOctober 11, 2024
Certification dateOctober 11, 2024
Mailing address1196 E Preston Dr, Alpine, UT 84004-1937

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