Bridgeview Dental Group LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1137 Issued in AK

Legal business name

BRIDGEVIEW DENTAL GROUP LLC

Practice address

413 Rezanof Dr E
Kodiak, AK 99615-6367

Phone

(907) 622-7874

Fax

(907) 622-7872

NPI assigned

Feb 12, 2016

Last updated

Feb 12, 2016By 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

James Penfield, DDS

Title

Owner

Phone

(907) 622-7874

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1455235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455235200000",
    "number": "1134588619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12641 OLD GLENN HWY STE 204",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "99577",
            "telephone_number": "907-622-7874",
            "fax_number": "907-622-7872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 REZANOF DR E",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156367",
            "telephone_number": "907-622-7874",
            "fax_number": "907-622-7872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEVIEW DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-12",
        "last_updated": "2016-02-12",
        "status": "A",
        "authorized_official_last_name": "PENFIELD",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-622-7874",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "1137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alana Branson, PA
• Candace Michelle Branson, B.A.
• Katelyn Braswell
• Alison Marie Bravo
• Brett a. Bass, DDS PC
• Kimberly D Britt, DENTAL ASSISTANT
• William Robert Brouhard, HEALTH SERVICES TECH
• Christina Marie Brown, HEALTH SERVICE TECH
• Jonathan Brubaker
• Katherine Buchinger, M. ED.

• General Practice Dentistry in Kodiak, AK
• Providers in Kodiak, AK by specialty
• General Practice Dentistry in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; 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.