Prairie Rose Family Dentists

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

PRAIRIE ROSE FAMILY DENTISTS

Practice address

121 E Front Ave
Bismarck, ND 58504-5589

Phone

(701) 223-1194

Fax

(701) 250-9614

NPI assigned

Nov 13, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bradley E King, DDS

Title

President

Phone

(701) 223-1194

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1144391632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E FRONT AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045589",
            "telephone_number": "701-223-1194",
            "fax_number": "701-250-9614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 E FRONT AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045589",
            "telephone_number": "701-223-1194",
            "fax_number": "701-250-9614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIE ROSE FAMILY DENTISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-223-1194",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41286",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Portra, M.S., CCC-SLP
• Monika Pothamsetti, MD
• Massa Poure
• Prairie Assisted Living Services LLC
• Prairie Point Counseling PLLC
• Prairie Rose Family Dentists
• Prairie Sea Hearing Center LLC
• Prairie Sinus Ear & Allergy PC
• Roja P Prathipati, MD
• Johanes I. Prawira, MD

• Dentist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Dentist in North Dakota

• 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.