Bridgeport Dental Services, Inc.

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

010435 Issued in MO

Legal business name

BRIDGEPORT DENTAL SERVICES, INC.

Practice address

12 Westbury Dr
Suite D
Saint Charles, MO 63301-2543

Phone

(636) 925-2787

Fax

(636) 925-2829

NPI assigned

Jan 6, 2009

Last updated

Jan 6, 2009By 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

Kristine Usry

Title

Manager of Finance

Phone

(636) 925-2787

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Walter Robert Pfitzinger, D.D.S, M.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbia, MO
  • NPI 1770588972
  NPD (past)

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

{
    "created_epoch": "1231200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1225274681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 WESTBURY DR",
            "address_2": "SUITE D",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012543",
            "telephone_number": "636-925-2787",
            "fax_number": "636-925-2829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 WESTBURY DR",
            "address_2": "SUITE D",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012543",
            "telephone_number": "636-925-2787",
            "fax_number": "636-925-2829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGEPORT DENTAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-06",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "USRY",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "MANAGER OF FINANCE",
        "authorized_official_telephone_number": "636-925-2787"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MO",
            "license": "010435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith Ann Breining, RPH
• Dan Brennan
• Terri L Brennan, CRNFA
• Pamela J Breshears, P.T.
• Donna Link Bresler, RN, ANP
• Bright Path DME LLC
• Bright Smiles, LLC
• Brightest Day Home Health Care LLC
• Kelly Elizabeth Bristol, LPC
• Michelle Brock, LCSW

• Health Maintenance Organization in Saint Charles, MO
• Providers in Saint Charles, MO by specialty
• Health Maintenance Organization in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; 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.