BAOKOU BUNGARD-THAO (NPI# 1609480011) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609480011 |
| Entity Type | Individual |
| Full Name | BAOKOU BUNGARD-THAO |
| Practice Address |
7300 N Perimeter Rd Great Falls MT 59402-6701 |
| Practice Telephone | 4067314393 |
| Mailing Telephone | 4067314393 |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 126800000X | Dental Assistant | Dental Providers |
| Street Address |
7300 N PERIMETER RD |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59402-6701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609480060 | Dominique Edwards | Dental Assistant | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2020-09-03 |
| 1659906527 | Kelsey Gavin Aldridge | Military Health Care Provider | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2020-03-11 |
| 1891335881 | Lidya Paola Galvan Reyes | Military Health Care Provider | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2020-01-08 |
| 1558829408 | Tyler C Mcdaniel | Psychologist | 7300 N Perimeter Rd, Great Falls, MT 59402 | 2019-03-11 |
| 1548730724 | Brennan Kaine Jacobs | Pharmacist | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2018-11-29 |
| 1639644339 | Anton Garcia Hayward | Military Health Care Provider | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2018-10-09 |
| 1609327428 | Usaf | Military Health Care Provider | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2016-10-17 |
| 1144773698 | Justin Shirk | Dentist | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2016-08-02 |
| 1407257793 | Shaun Mark Saunders | Physician Assistant | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2014-09-06 |
| 1700125960 | Chad Bechtle | Optometrist | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2013-02-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194255166 | Jonathan Tankersley | Dentist | 7300 Perimeter Rd, Malmstrom Afb, Mt 59402, Dental Clinic, Apo, AA 59402 | 2017-06-13 |
| 1780061960 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 7200 Perimeter Rd., Bldg 1340, Malmstrom Afb, MT 59402 | 2015-04-27 |
| 1396181533 | 341st Medical Group | Military/U.S. Coast Guard Pharmacy | 341 Mdg/mdss/sgsa 7300 N Perimeter Rd, Bldg 2040, Malstrom Afb, MT 59402 | 2013-05-15 |
| 1205098258 | Dennis Gordon Vanhook | Social Worker | 7300 N Peirmeter Road, 341st Medical Group, Malmstrom Afb, MT 59402 | 2008-07-01 |
| 1437205119 | Misty Dawn Robertson | Dental Hygienist | 3700 N Perimeter Road, Malmstrom Afb, MT 59402 | 2007-01-26 |
| 1699738278 | Carol F Nelson | Nurse Practitioner | 7300 North Perimeter Rd, Malmstrom Afb, MT 59402 | 2006-04-06 |
| 1952541716 | Stacey Renee Vierra | Physician Assistant | 7300 North Perimeter Road, 341 Medical Group, Malmstrom Afb, MT 59402 | 2009-03-05 |
| 1306094461 | Jeremy Gustafson | Pharmacist | 7300 North Perimeter Road, Malmstrom Afb, MT 59402 | 2008-09-03 |
| 1356329817 | Timothy Paul Gacioch | Physician Assistant | 4300 Perimeter Rd, (341st Med Group) Bldg 2040, Room S156, Malmstrom Afb, MT 59402-0001 | 2006-01-05 |
| 1104848159 | Malmstrom Air Force Base | Military Hospital | 7300 N Perimeter Rd Bldg 2040, 341 Mdos/sgomhf Malmstrom Afb, Great Falls, MT 59402-6701 | 2006-07-25 |
| Find all providers in zip 59402 | ||||
| Taxonomy Code | 126800000X |
| Grouping | Dental Providers |
| Classification | Dental Assistant |
| An individual who may or may not have completed an accredited dental assisting education program and who aids the dentist in providing patient care services and performs other nonclinical duties in the dental office or other patient care facility. The scope of the patient care functions that may be legally delegated to the dental assistant varies based on the needs of the dentist the educational preparation of the dental assistant and state dental practice acts and regulations. Patient care services are provided under the supervision of a dentist. To avoid misleading the public, no occupational title other than dental assistant should be used to describe this dental auxiliary. |
| Notes: Source: Comprehensive Policy Statement on Dental Auxiliaries, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609480060 | Dominique Edwards | Dental Assistant | 7300 N Perimeter Rd, Great Falls, MT 59402-6701 | 2020-09-03 |
| 1437573003 | Cascade Family Dentistry Pllc | Dental Assistant | 2507 6th Ave S, Great Falls, MT 59405-3013 | 2014-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083220149 | Mayra Y Corona | Dental Assistant | 7300 N Perimeter Rd, Malmstrom Afb, MT 59402-6701 | 2020-09-23 |
| City | GREAT FALLS |
| Zip Code | 59402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.