Advanced Dental Technologies Center

Primary specialty

DentistTaxonomy code 122300000X

License

1617 Issued in ND

Legal business name

ADVANCED DENTAL TECHNOLOGIES CENTER

Practice address

827 28TH St S Ste a
Fargo, ND 58103-8727

Phone

(701) 280-1020

Fax

(701) 280-1460

NPI assigned

Jun 15, 2015

Last updated

Jun 15, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. David Gordon Brant, DR.

Title

Dentist

Phone

(701) 280-1020

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1114308285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 28TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038727",
            "telephone_number": "701-280-1020",
            "fax_number": "701-280-1460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 28TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581038727",
            "telephone_number": "701-280-1020",
            "fax_number": "701-280-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL TECHNOLOGIES CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "BRANT",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GORDON",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "701-280-1020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DR."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ND",
            "license": "1617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.