DR. BRADLEY THAIN PORTER DDS
NPI 1023095734
Dentist - Oral and Maxillofacial Surgery in Mesa, AZ

Q: What is Bradley Porter's NPI number?

The NPI number for Bradley Porter is 1023095734. It was assigned to this individual provider in the NPPES registry on December 23, 2005.

Q: What is Bradley Porter's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: Is Bradley Porter enrolled in Medicare?

No. Bradley Porter has opted out of Medicare through May 11, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Bradley Porter was last updated on December 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 23, 2005Opted out of Medicare · through May 11, 2028

6755 E SUPERSTITION SPRINGS BLVD, SUITE 103, MESA, AZ 85206(480) 830-5866(480) 807-0606 Get Directions Write a Review

NPPES record last updated: December 4, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Bradley Thain Porter Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRADLEY THAIN PORTER DDS (NPI 1023095734) is an individual oral and maxillofacial surgery provider in Mesa, Arizona, licensed in Arizona (4124) and active in the NPI registry since December 2005. He has opted out of Medicare through May 11, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1023095734

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. BRADLEY THAIN PORTERCredential: DDS

Location Address6755 E SUPERSTITION SPRINGS BLVD, SUITE 103Mesa, AZ 85206-4373

Mailing Address6755 E Superstition Springs Blvd, Suite 103Mesa, AZ 85206-4373 · (480) 830-5866 · Fax (480) 807-0606

Phone(480) 830-5866

Fax(480) 807-0606

Sole ProprietorNo

Enumeration DateDecember 23, 2005

Last NPPES UpdateDecember 4, 2018

✔ NPI 1023095734 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in AZ · 4124

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

6755 E SUPERSTITION SPRINGS BLVD, Mesa, AZ 85206

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Other Identifiers 2

Medicaid2173766AZ

OtherAZ0482170AZ · Bcbs

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Bradley Thain Porter Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from May 11, 2016 through May 11, 2028.

Opt-Out Effective DateMay 11, 2016

Opt-Out In Effect ThroughMay 11, 2028Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 85206 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROLLINS & PETERSEN ORTHODONTICS PLC

Dentist (Orthodontics and Dentofacial Orthopedics)

6755 E SUPERSTITION SPRINGS BLVD, STE 201
MESA, AZ 85206

Maricopa County (480) 924-2880

EAST VALLEY PERIODONTICS

Dentist (Periodontics)

6755 E SUPERSTITION SPRINGS BLVD, STE. 102
MESA, AZ 85206

Maricopa County (480) 218-7590

MARK S. HAMBLIN, D.D.S., P.C.

Dentist

6755 E SUPERSTITION SPRINGS BLVD, SUITE #202
MESA, AZ 85206

Maricopa County (480) 981-3311

ARLON M PETERSEN DMD

Dentist (Orthodontics and Dentofacial Orthopedics)

6755 E SUPERSTITION SPRINGS BLVD, STE 201
MESA, AZ 85206

Maricopa County (480) 924-2880

DERRICK J DICKERSON DMD

Dentist (General Practice)

6755 E SUPERSTITION SPRINGS BLVD, 203
MESA, AZ 85206

Maricopa County (480) 218-6030

DICKERSON ENTERPRISES, INCORPORATED

Dentist

6755 E SUPERSTITION SPRINGS BLVD, SUITE 203
MESA, AZ 85206

Maricopa County (480) 218-6030

DR. MARK S. HAMBLIN D.D.S.

Dentist (General Practice)

6755 E SUPERSTITION SPRINGS BLVD, SUITE #202
MESA, AZ 85206

Maricopa County (480) 981-3311

DR. BRENT RUSSELL BOYSE DDS

Dentist (Oral and Maxillofacial Surgery)

6755 E SUPERSTITION SPRINGS BLVD, SUITE 103
MESA, AZ 85206

Maricopa County (480) 830-5866

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bradley Porter's NPI number?

The NPI number for Bradley Porter is 1023095734. It was assigned to this individual provider in the NPPES registry on December 23, 2005.

Where is Bradley Porter located?

Bradley Porter practices at 6755 E Superstition Springs Blvd Suite 103, Mesa, AZ 85206. The listed phone number is (480) 830-5866.

What is Bradley Porter's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Bradley Porter enrolled in Medicare?

No. Bradley Porter has opted out of Medicare through May 11, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Bradley Porter accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross Blue Shield of Arizona, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 7 other insurers list Bradley Porter as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bradley Porter was last updated on December 4, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.