Wellspring Dental of Bedford, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

03777 Issued in NH

Legal business name

WELLSPRING DENTAL OF BEDFORD, LLC

Doing business as

Wellspring Dental Group

Practice address

169 S River Rd
Ste 6
Bedford, NH 03110-6971

Phone

(603) 232-5490

NPI assigned

Jul 21, 2014

Organization subpart

No

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

Authorized official

Name

Dr. David B Chan, DMD

Title

Dentist

Phone

(603) 232-5490

Specialties & licenses 1

Addresses

Other names 1

• Wellspring Dental Group Doing business as

Locations

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405900800000",
    "number": "1336556554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 S RIVER RD",
            "address_2": "STE 6",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 S RIVER RD",
            "address_2": "STE 6",
            "city": "BEDFORD",
            "state": "NH",
            "postal_code": "031106971",
            "telephone_number": "603-232-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING DENTAL OF BEDFORD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "603-232-5490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NH",
            "license": "03777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellspring Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jennifer W Weidner, MD
• Andrea Weilbrenner
• Jackson Mitchell Weinbeck, B.A.
• Lisa Weldon, PMH-NP
• Wellbridge Physical Therapy, LLC
• Patricia Wenrich Maynard, MSW, LICSW
• Joshua West
• Shannon L Wheaton, PT
• Sarah Wheeler, FNP
• Trisha Anne Wheeler

• Dentist in Bedford, NH
• Providers in Bedford, NH by specialty
• Dentist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2014; 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.