Bismark Lake LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BISMARK LAKE LLC

Practice address

14175 W Indian School Rd Ste B6
Goodyear, AZ 85395-8490

Phone

(602) 902-0275

NPI assigned

Apr 8, 2026

Last updated

Apr 8, 2026By 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

Michael Hunt

Title

Owner

Phone

(480) 280-4416

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.

• Jonathon Edwards

  • Dentist
  • Gilbert, AZ
  • NPI 1013377829
  NPD

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

{
    "created_epoch": "1775606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775606400000",
    "number": "1285576058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1786 S 141ST PL",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852954752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14175 W INDIAN SCHOOL RD STE B6",
            "city": "GOODYEAR",
            "state": "AZ",
            "postal_code": "853958490",
            "telephone_number": "602-902-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BISMARK LAKE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-08",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A",
        "authorized_official_last_name": "HUNT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-280-4416"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maryna Bilyk, MS
• Marc Bingaman, PHARM.D.
• Bio-Medical Applications of Arizona, LLC (Fresenius Medical Care Goodyear)
• Bio-Medical Applications of Arizona, LLC (FMC Dialysis Services Palm Valley)
• Biomechanix Physical Therapy, PLC
• Blackbridge Behavioral Health LLC
• Casey Marie Blaesing, OTR/L
• Randy Bland
• Randall J Blazic, DDS MD
• Blessing Care

• Dental Clinic/Center in Goodyear, AZ
• Providers in Goodyear, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2026; 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.