Bullhead City Dentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BULLHEAD CITY DENTISTRY LLC

Practice address

2600 Silver Creek Rd
Bullhead City, AZ 86442-8337

Phone

(623) 289-2580

NPI assigned

Feb 22, 2022

Last updated

Feb 22, 2022By 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

Tera Niedens

Title

Accountant

Phone

(623) 289-2616

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1645488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645488000000",
    "number": "1922754662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34225 N 27TH DR STE 241",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850856091",
            "telephone_number": "623-289-2616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SILVER CREEK RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864428337",
            "telephone_number": "623-289-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BULLHEAD CITY DENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-22",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A",
        "authorized_official_last_name": "NIEDENS",
        "authorized_official_first_name": "TERA",
        "authorized_official_title_or_position": "ACCOUNTANT",
        "authorized_official_telephone_number": "623-289-2616"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Bullhead",
            "affiliation": "N",
            "endpointDescription": "Bullhead City",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2600 Silver Creek Rd",
            "city": "Bullhead City",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "864428337",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Meredith Lynn Brumfield, COTA/L
• Charles Eugene Bruso, M.D.
• Ryan Sabado Buenaventura, PHARMD
• Clayson J Bufton, RN, CRNA
• Bullhead City Clinic Corp
• Bullhead City Elementary
• Bullhead City Elementary School District
• Bullhead City Fire Department
• Bullhead City Hospital Corporation (WARMC Imaging Center)
• Bullhead City Hospital Corporation

• Dental Clinic/Center in Bullhead City, AZ
• Providers in Bullhead City, AZ by specialty
• Dental Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.