NPIMap

Organization Active NPI

Bridging the Dental Gap Inc

  • Dental Clinic/Center
  • Bismarck, ND
National Provider Identifier
1649338377
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
BRIDGING THE DENTAL GAP INC
Practice address
1223 S 12TH St
Ste 1
Bismarck, ND 58504
Phone
(701) 221-0518
Fax
(701) 221-0537
NPI assigned
Dec 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Marcia A Olson
Title
Executive Director
Phone
(701) 221-0518

Specialties & licenses 1

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

Addresses

Primary practice location

1223 S 12TH St
Ste 1
Bismarck, ND 58504

Mailing address

1223 S 12TH St
Ste 1 Bridging the Dental Gap Inc
Bismarck, ND 58504
Phone (701) 221-0518

Other identifiers 1

IdentifierTypeStateIssuer
41340MedicaidND

National Provider Directory

National Provider Directory

Locations

1223 S 12th St
Ste 1
Bismarck, ND 58504
Phone (701) 221-0518

Practitioners & affiliated clinicians

Practitioners 9

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": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649338377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1223 S 12TH ST",
            "address_2": "STE 1 BRIDGING THE DENTAL GAP INC",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58504",
            "telephone_number": "701-221-0518",
            "fax_number": "701-221-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 S 12TH ST",
            "address_2": "STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58504",
            "telephone_number": "701-221-0518",
            "fax_number": "701-221-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIDGING THE DENTAL GAP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "701-221-0518"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41340",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.