NPIMap

Organization Active NPI

Bridge Street Dental, PLLC

  • Dental Clinic/Center
  • Brighton, CO
National Provider Identifier
1306347182
Registry record updated Feb 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8920 Issued in CO
Legal business name
BRIDGE STREET DENTAL, PLLC
Practice address
19 N 42ND Ave
Brighton, CO 80601-4351
Phone
(720) 583-1425
NPI assigned
Feb 26, 2018
Last updated
Feb 26, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2018

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

Authorized official

Name
Dr. Travis Whiteley, DMDNPI 1659571727
Title
President
Phone
(801) 376-9484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 8920 CO Primary

Addresses

Primary practice location

19 N 42ND Ave
Brighton, CO 80601-4351

Mailing address

19 N 42ND Ave
Brighton, CO 80601-4351

National Provider Directory

National Provider Directory

Locations

19 N 42nd Ave
Brighton, CO 80601
Phone (720) 583-1425

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1519603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519603200000",
    "number": "1306347182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 N 42ND AVE",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 N 42ND AVE",
            "city": "BRIGHTON",
            "state": "CO",
            "postal_code": "806014351",
            "telephone_number": "720-583-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGE STREET DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-26",
        "last_updated": "2018-02-26",
        "status": "A",
        "authorized_official_last_name": "WHITELEY",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-376-9484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "CO",
            "license": "8920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brighton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2018; 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.