NPIMap

Organization Active NPI

Mpda Bridgeport LLC

Doing business as Bridgeport Family Dental

  • General Practice Dentistry
  • Bridgeport, NE
National Provider Identifier
1336966795
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MPDA BRIDGEPORT LLC
Doing business as
Bridgeport Family Dental
Practice address
1006 Main St
Bridgeport, NE 69336-4035
Phone
(308) 262-1434
NPI assigned
Sep 25, 2024
Last updated
Sep 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Authorized official

Name
Benjamin Lashley, DDSNPI 1619993862
Title
Partner
Phone
(308) 534-1289

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
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1006 Main St
Bridgeport, NE 69336-4035

Mailing address

1006 Main St
Bridgeport, NE 69336-4035
Phone (308) 262-1434

Other names 1

  • Bridgeport Family Dental Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1336966795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1006 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "NE",
            "postal_code": "693364035",
            "telephone_number": "308-262-1434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 MAIN ST",
            "city": "BRIDGEPORT",
            "state": "NE",
            "postal_code": "693364035",
            "telephone_number": "308-262-1434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MPDA BRIDGEPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "LASHLEY",
        "authorized_official_first_name": "BENJAMIN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "308-534-1289",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgeport Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bridgeport, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.