NPIMap

Organization Active NPI

Cambridge Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Cambridge, MN
National Provider Identifier
1124244603
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
8936 Issued in MN
Legal business name
CAMBRIDGE ORTHODONTICS PA
Practice address
140 Birch St N
#106
Cambridge, MN 55008
Phone
(763) 689-3134
Fax
(763) 689-6609
NPI assigned
Apr 17, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Bradley L Videen, DDS MSNPI 1407025521
Title
100 Percent Shareholder of S Corp
Phone
(763) 689-3134

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 8936 MN Primary

Addresses

Primary practice location

140 Birch St N
#106
Cambridge, MN 55008

Mailing address

140 Birch St N
#106
Cambridge, MN 55008
Phone (763) 689-3134

Other names 1

  • Bradley L Videen DDS MS Other name

National Provider Directory

National Provider Directory

Locations

140 Birch St N
Ste 106
Cambridge, MN 55008
Phone (763) 689-3134

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124244603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 BIRCH ST N",
            "address_2": "#106",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "55008",
            "telephone_number": "763-689-3134",
            "fax_number": "763-689-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 BIRCH ST N",
            "address_2": "#106",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "55008",
            "telephone_number": "763-689-3134",
            "fax_number": "763-689-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE ORTHODONTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VIDEEN",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "100 PERCENT SHAREHOLDER OF S CORP",
        "authorized_official_telephone_number": "763-689-3134",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "8936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bradley L Videen DDS MS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cambridge, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.