BFD Madisonville Associates LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BFD MADISONVILLE ASSOCIATES LLC

Doing business as

Bridgelake Family Dentistry

Practice address

109 Pine Creek Drive
Suite B
Madisonville, LA 70447

Phone

(985) 590-5175

Fax

(985) 590-5165

NPI assigned

May 29, 2020

Last updated

May 29, 2020By 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

Mark Tinney, DDS

Title

Owner/Dentist

Phone

(985) 590-5175

Specialties & licenses 1

Addresses

Other names 1

• Bridgelake Family Dentistry Doing business as

Locations

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

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1590710400000",
    "number": "1306460001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 PINE CREEK DRIVE",
            "address_2": "SUITE B",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "70447",
            "telephone_number": "985-590-5175",
            "fax_number": "985-590-5165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 PINE CREEK DRIVE",
            "address_2": "SUITE B",
            "city": "MADISONVILLE",
            "state": "LA",
            "postal_code": "70447",
            "telephone_number": "985-590-5175",
            "fax_number": "985-590-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BFD MADISONVILLE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A",
        "authorized_official_last_name": "TINNEY",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "985-590-5175",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgelake Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Madisonville, LA
• Providers in Madisonville, LA by specialty
• Dentist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.