NPIMap

Organization Active NPI

Orthodontic Associates of Greeley PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Greeley, CO
National Provider Identifier
1881709913
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
6883 Issued in CO
Legal business name
ORTHODONTIC ASSOCIATES OF GREELEY PC
Practice address
3400 W 16TH St
BLDG 4-V
Greeley, CO 80634-6862
Phone
(970) 356-5900
Fax
(970) 356-2418
NPI assigned
Aug 20, 2006
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
Dr. Bradford Newhall Edgren, D.D.S., M.S.NPI 1063532448
Title
Orthodontist
Phone
(970) 356-5900

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
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223X0400X 6883 CO Primary

Addresses

Primary practice location

3400 W 16TH St
BLDG 4-V
Greeley, CO 80634-6862

Mailing address

3400 W 16TH St
BLDG 4-V
Greeley, CO 80634-6862
Phone (970) 356-5900

National Provider Directory

National Provider Directory

Locations

3400 W 16th St
Bldg 4V
Greeley, CO 80634
Phone (970) 356-5900

Practitioners & affiliated clinicians

Practitioners 2

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": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881709913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 W 16TH ST",
            "address_2": "BLDG 4-V",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346862",
            "telephone_number": "970-356-5900",
            "fax_number": "970-356-2418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 W 16TH ST",
            "address_2": "BLDG 4-V",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806346862",
            "telephone_number": "970-356-5900",
            "fax_number": "970-356-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC ASSOCIATES OF GREELEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EDGREN",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "NEWHALL",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "970-356-5900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S., M.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CO",
            "license": "6883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greeley, CO

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.