Affordable Dentures & Implants - St. Cloud, P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

AFFORDABLE DENTURES & IMPLANTS - ST. CLOUD, P.C.

Practice address

3959 2ND St S Ste 207
Saint Cloud, MN 56301-3877

Phone

(320) 371-0234

NPI assigned

Aug 8, 2023

Last updated

Aug 8, 2023By 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

Bradley Sim, DDS

Title

Owner

Phone

(320) 371-0234

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1691452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1487337424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 2ND ST S STE 207",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013877",
            "telephone_number": "320-371-0234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 2ND ST S STE 207",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013877",
            "telephone_number": "320-371-0234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFORDABLE DENTURES & IMPLANTS - ST. CLOUD, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-08",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "SIM",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-371-0234",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; 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.