NPIMap

Organization Active NPI

Maple Family Dental P.C.

  • Dental Clinic/Center
  • Horace, ND
National Provider Identifier
1487105276
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
2046 Issued in ND
Legal business name
MAPLE FAMILY DENTAL P.C.
Practice address
594 Main St N
Horace, ND 58047-4640
Phone
(701) 552-6001
NPI assigned
Oct 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Authorized official

Name
Dr. Jonathan Bultema, D.D.SNPI 1669704300
Title
President
Phone
(701) 552-6001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 2046 ND Primary

Addresses

Primary practice location

594 Main St N
Horace, ND 58047-4640

Mailing address

594 Main St N
Horace, ND 58047-4640
Phone (701) 552-6001

National Provider Directory

National Provider Directory

Locations

594 Main St N
Horace, ND 58047
Phone (701) 552-6001

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476748800000",
    "number": "1487105276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "594 MAIN ST N",
            "city": "HORACE",
            "state": "ND",
            "postal_code": "580474640",
            "telephone_number": "701-552-6001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "594 MAIN ST N",
            "city": "HORACE",
            "state": "ND",
            "postal_code": "580474640",
            "telephone_number": "701-552-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE FAMILY DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-18",
        "last_updated": "2016-10-18",
        "status": "A",
        "authorized_official_last_name": "BULTEMA",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-552-6001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ND",
            "license": "2046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Horace, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; 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.