Affordable Dentures & Implants - Bloomington IV, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

AFFORDABLE DENTURES & IMPLANTS - BLOOMINGTON IV, P.C.

Practice address

3800 W Industrial Blvd
Bloomington, IN 47403-5139

Phone

(812) 339-9899

NPI assigned

Aug 29, 2022

Last updated

Aug 29, 2022By 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

Jae Lee

Title

DMD

Phone

(812) 339-9899

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661731200000",
    "number": "1225758576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W INDUSTRIAL BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035139",
            "telephone_number": "812-339-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W INDUSTRIAL BLVD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035139",
            "telephone_number": "812-339-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - BLOOMINGTON IV, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-29",
        "last_updated": "2022-08-29",
        "certification_date": "2022-08-29",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAE",
        "authorized_official_title_or_position": "DMD",
        "authorized_official_telephone_number": "812-339-9899"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Bloomington, IN
• Providers in Bloomington, IN by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2022; 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.