Bryan J. Ophaug, D.D.S., P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11890 Issued in MN

Legal business name

BRYAN J. OPHAUG, D.D.S., P.A.

Practice address

7123 Bass Lake Rd
New Hope, MN 55428-3822

Phone

(763) 533-5359

Fax

(763) 533-0010

NPI assigned

Jul 22, 2008

Last updated

Jul 22, 2008By 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

Dr. Bryan Jeffrey Ophaug, D.D.S.NPI 1558401240

Title

President

Phone

(763) 533-5359

Specialties & licenses 1

Addresses

Other names 1

• Bass Lake Dental Group Other name

Locations

Practitioners 2

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.

• Bryan Jeffrey Ophaug, D.D.S.

  • General Practice Dentistry
  • New Hope, MN
  • NPI 1558401240
  NPD (past) Authorized official
• Robert Duane Thompson, DDS

  • General Practice Dentistry
  • New Hope, MN
  • NPI 1306909015
  NPD (past)

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1639334428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7123 BASS LAKE RD",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283822",
            "telephone_number": "763-533-5359",
            "fax_number": "763-533-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7123 BASS LAKE RD",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554283822",
            "telephone_number": "763-533-5359",
            "fax_number": "763-533-0010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN J. OPHAUG, D.D.S., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "OPHAUG",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-533-5359",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bass Lake Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Abigail Rose Brooks
• Alan Richard Brosseau, R.PH.
• James David Brown
• Michael Brown
• Natalie Dennen Brown, M.S.W., L.I.C.S.W
• Jordyn Leigh Bryant, OTR/L
• Gina Marie Buchal, ADT
• Lisa Burkauskas, NP
• Elizabeth Burton, PTA
• Meghan Cain-Moss, LICSW

• General Practice Dentistry in New Hope, MN
• Providers in New Hope, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.