NPIMap

Organization Active NPI

Anderson & Breding Dental LLC

  • Dental Clinic/Center
  • Fargo, ND
National Provider Identifier
1215278676
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
ND2045 Issued in ND
Legal business name
ANDERSON & BREDING DENTAL LLC
Practice address
4521 38TH Ave. S.
Fargo, ND 58104
Phone
(701) 232-1368
Fax
(701) 232-4746
NPI assigned
Mar 11, 2013
Last updated
Sep 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Authorized official

Name
Dr. Bradley Jon Anderson, DDSNPI 1174758361
Title
Co-Owner
Phone
(701) 232-1368

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X ND1601 ND
Dental Clinic/Center 261QD0000X NU
Dental Clinic/Center 261QD0000X ND2045 ND Primary

Addresses

Primary practice location

4521 38TH Ave. S.
Fargo, ND 58104

Mailing address

4521 38TH Ave. S.
Fargo, ND 58104
Phone (701) 232-1368

Other names 1

  • Anderson Dental LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

4521 38th Ave S
Fargo, ND 58104
Phone (701) 232-1368

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1215278676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4521 38TH AVE. S.",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-232-1368",
            "fax_number": "701-232-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4521 38TH AVE. S.",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-232-1368",
            "fax_number": "701-232-4746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON & BREDING DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-11",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "701-232-1368",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ND",
            "license": "ND1601",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ND",
            "license": "ND2045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anderson Dental LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.