DR. BRADLEY DALE HARRELSON D.M.D.
NPI 1386836427
Dentist - Oral and Maxillofacial Surgery in Niceville, FL

Q: What is Bradley Harrelson's NPI number?

The NPI number for Bradley Harrelson is 1386836427. It was assigned to this individual provider in the NPPES registry on August 13, 2007.

Q: What is Bradley Harrelson's specialty?

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

Q: Is Bradley Harrelson enrolled in Medicare?

No. Bradley Harrelson has opted out of Medicare through November 25, 2026. 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 Harrelson was last updated on April 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 August 13, 2007Opted out of Medicare · through Nov 25, 2026

4400 E HIGHWAY 20 STE 111, NICEVILLE, FL 32578(850) 897-4171(850) 897-4622 Get Directions Write a Review

NPPES record last updated: April 22, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 22, 2024, Apr 27, 2018 (2 updates tracked since 2018).

On this page

About Dr. Bradley Dale Harrelson D.m.d. NPPES

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

DR. BRADLEY DALE HARRELSON D.M.D. (NPI 1386836427) is an individual oral and maxillofacial surgery provider in Niceville, Florida, licensed in Florida (DN24799) and active in the NPI registry since August 2007. He has opted out of Medicare through November 25, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1386836427

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. BRADLEY DALE HARRELSONCredential: D.M.D.

Location Address4400 E HIGHWAY 20 STE 111Niceville, FL 32578-9735

Mailing Address4400 E Highway 20 Ste 111Niceville, FL 32578-9735 · (850) 897-4171 · Fax (850) 897-4622

Phone(850) 897-4171

Fax(850) 897-4622

Sole ProprietorYes

Enumeration DateAugust 13, 2007

Last NPPES UpdateApril 22, 20242 updates tracked since enumeration

NPPES CertifiedApril 22, 2024

✔ NPI 1386836427 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

Licenses✔ Licensed in FL · DN24799✔ Licensed in MS · OS-519-16

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.

Also ListedDentistTaxonomy 122300000X · License 3428-07 (MS)

4400 E HIGHWAY 20 STE 111, Niceville, FL 32578

Open in Google Maps ↗

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 Dale Harrelson D.m.d. 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 November 25, 2020 through November 25, 2026.

Opt-Out Effective DateNovember 25, 2020

Opt-Out In Effect ThroughNovember 25, 2026Opt-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 32578 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

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 Harrelson's NPI number?

The NPI number for Bradley Harrelson is 1386836427. It was assigned to this individual provider in the NPPES registry on August 13, 2007.

Where is Bradley Harrelson located?

Bradley Harrelson practices at 4400 E Highway 20 Ste 111, Niceville, FL 32578. The listed phone number is (850) 897-4171.

What is Bradley Harrelson's specialty?

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

Is Bradley Harrelson enrolled in Medicare?

No. Bradley Harrelson has opted out of Medicare through November 25, 2026. 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.

When was this NPI record last updated?

The NPPES record for Bradley Harrelson was last updated on April 22, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.