BRADLEY D. BOURCY DDS MS AND RYAN D. HARBERTSON DDS MS NPI 1417967290

NPI Information

  • NPI: 1417967290
  • Provider Name: BRADLEY D. BOURCY DDS MS AND RYAN D. HARBERTSON DDS MS
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Organization
  • Former Legal Business Name: DAVID L. TAGGE, D.D.S., M.S.D. AND BRADLEY D. BOURCY, D.D.S., M.S., IN
  • Address: 850 E. GRAND AVENUE
    SUITE A
    ESCONDIDO, CA
    ZIP 92025
  • Phone: (760) 741-4061

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NPI Details

BRADLEY D. BOURCY DDS MS AND RYAN D. HARBERTSON DDS MS is a periodontics dentist in Escondido, CA. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. BRADLEY D. BOURCY DDS MS AND RYAN D. HARBERTSON DDS MS NPI is 1417967290. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is David L. Tagge, D.d.s., M.s.d. And Bradley D. Bourcy, D.d.s., M.s., In.

The provider's business location address is:

850 E. GRAND AVENUE
SUITE A
ESCONDIDO, CA
ZIP 92025-435
Phone: (760) 741-4061
Fax: (760) 432-8764

The provider's authorized official is Ryan D. Harbertson .
The authorized official title is Owner/partner and has the following contact phone number (760) 741-4061.

The enumeration date for this NPI number is 8/8/2006 and was last updated on 1/10/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics042637CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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