NPIMap

Organization Active NPI

Bradshaw Mountain Family Dental Group PC

  • Dental Clinic/Center
  • Prescott Valley, AZ
National Provider Identifier
1972773141
Registry record updated Mar 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D5639 Issued in AZ
Legal business name
BRADSHAW MOUNTAIN FAMILY DENTAL GROUP PC
Practice address
7136 Pav Way
Prescott Valley, AZ 86314-2264
Phone
(928) 775-9495
NPI assigned
Mar 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2008

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

Authorized official

Name
Dr. David Frausto Jr., DDSNPI 1619021425
Title
President
Phone
(928) 775-9495

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
Dental Clinic/Center 261QD0000X D5639 AZ Primary

Addresses

Primary practice location

7136 Pav Way
Prescott Valley, AZ 86314-2264

Mailing address

7136 Pav Way
Prescott Valley, AZ 86314-2264
Phone (928) 775-9495

National Provider Directory

National Provider Directory
Tax ID family
Bradshaw Family Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1204588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204588800000",
    "number": "1972773141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7136 PAV WAY",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142264",
            "telephone_number": "928-775-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7136 PAV WAY",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142264",
            "telephone_number": "928-775-9495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADSHAW MOUNTAIN FAMILY DENTAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A",
        "authorized_official_last_name": "FRAUSTO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-775-9495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "AZ",
            "license": "D5639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott Valley, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 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.