Weaver Family Dentisty PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2129 Issued in ND

Legal business name

WEAVER FAMILY DENTISTY PA

Doing business as

Advantage Dental

Practice address

4302 13TH Ave S
Fargo, ND 58103-3395

Phone

(208) 284-0054

NPI assigned

Apr 13, 2009

Last updated

Jul 3, 2012By 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. James R Weaver, DDSNPI 1417175647

Title

President

Phone

(208) 284-0054

Specialties & licenses 1

Addresses

Other names 1

• Advantage Dental Doing business as

Practitioners 1

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.

• James R Weaver, D.D.S.

  • General Practice Dentistry
  • Lafayette, IN
  • NPI 1417175647
  NPD (past) Authorized official

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

{
    "created_epoch": "1239580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1341273600000",
    "number": "1992948590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3974 BELL CT",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836861411",
            "telephone_number": "208-284-0054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4302 13TH AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581033395",
            "telephone_number": "208-284-0054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEAVER FAMILY DENTISTY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-13",
        "last_updated": "2012-07-03",
        "status": "A",
        "authorized_official_last_name": "WEAVER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-284-0054",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advantage Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Kathryn Wayne, RN
• Kari Wayne
• Kathryn Taylor Wayt, LPCC
• We Care Home Care LLC
• We Rock the Spectrum - North Dakota
• Veronica L Webb, NP-C
• Brailyn Weber, MD
• Carolyn Weber, OTR/L
• Darci Weber
• Kristin Weber, LPCC

• General Practice Dentistry in Fargo, ND
• Providers in Fargo, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.