Bridge Dental Care, PLLC.

Primary specialty

DentistTaxonomy code 122300000X

License

043458-1 Issued in NY

Legal business name

BRIDGE DENTAL CARE, PLLC.

Practice address

375 W Route 59
Spring Valley, NY 10977-5339

Phone

(845) 356-3353

Fax

(834) 356-3376

NPI assigned

May 8, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Junsung Ha, DDS

Title

Managing Member

Phone

(845) 356-3353

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1399507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399507200000",
    "number": "1144631474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 W ROUTE 59",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775339",
            "telephone_number": "845-356-3353",
            "fax_number": "834-356-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 W ROUTE 59",
            "city": "SPRING VALLEY",
            "state": "NY",
            "postal_code": "109775339",
            "telephone_number": "845-356-3353",
            "fax_number": "834-356-3376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE DENTAL CARE, PLLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-08",
        "last_updated": "2014-05-08",
        "status": "A",
        "authorized_official_last_name": "HA",
        "authorized_official_first_name": "JUNSUNG",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "845-356-3353",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "043458-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03779288",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; 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.