PARK RIVER DENTAL, PC (NPI# 1174666119) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174666119 |
| Entity Type | Organization |
| Organization Name | PARK RIVER DENTAL, PC |
| Other Organization Name | PARK RIVER DENTAL |
| Practice Address |
418 Briggs Avenue Park River ND 58270-0662 |
| Mailing Address |
Po Box 662 Park River ND 58270-0662 |
| Practice Telephone | 7012846131 |
| Mailing Telephone | 7012846131 |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2014-06-03 |
| Authorized Official Name | DR. BRIAN JAMES LARSON (OWNER/DENTIST PRESIDENT) |
| Authorized Official Telephone | 7012846131 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
1355 | ND | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
1805 | ND | Dental Providers |
| Other Name | Type Code |
|---|---|
| Park River Dental | Doing Business As Name - Organization |
| Street Address |
418 BRIGGS AVENUE |
| City | PARK RIVER |
| State | ND |
| Zip Code | 58270-0662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740769595 | The Evangelical Lutheran Good Samaritan Society | Nurse Practitioner | 301 S Highway 12b, Park River, ND 58270 | 2018-08-13 |
| 1104317189 | Paul Benedict Dusek | Dentist | 321 Briggs Ave S Ste 3, Park River, ND 58270 | 2018-05-24 |
| 1669880845 | Lifetime Dental, PC | Clinic/Center | 321 Briggs Ave S, Suite 3, Park River, ND 58270 | 2014-07-31 |
| 1063850436 | Achieve Therapy LLC | Physical Therapist | 102 4th St W, Park River, ND 58270 | 2013-06-07 |
| 1740473800 | Riverview Healthcare Association | Clinic/Center | 115 Vivian St, Park River, ND 58270 | 2007-08-22 |
| 1285847269 | Brian James Larson | Dentist | 418 Briggs Ave S, Park River, ND 58270 | 2007-05-07 |
| 1033137070 | Roberta L Ekman | Dentist | 321 Briggs Ave, Park River, ND 58270 | 2006-07-17 |
| 1679128664 | Lyndsi E Klundt | Physical Therapist | 102 4th St W, Park River, ND 58270 | 2019-08-06 |
| 1508426735 | Allie Beneda | Physical Therapy Assistant | 115 Vivian St., Park River, ND 58270 | 2019-06-19 |
| 1770795767 | Laurelyn Joann Larson | Pharmacist | Highway 17, Park River, ND 58270 | 2007-05-04 |
| Find all providers in zip 58270 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285847269 | Brian James Larson | Dentist | 418 Briggs Ave S, Park River, ND 58270 | 2007-05-07 |
| 1033137070 | Roberta L Ekman | Dentist | 321 Briggs Ave, Park River, ND 58270 | 2006-07-17 |
| 1295938504 | Nicholas Dennis Beneda | Dentist | 418 Briggs Ave S, Park River, ND 58270-0662 | 2007-06-06 |
| 1720291701 | Gerald Duane Larson | Dentist | 418 Briggs Ave S, Park River, ND 58270-0662 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174144851 | Robert A. Bond, D.d.s. | Dentist | 2851 University Dr S, Fargo, ND 58103-6029 | 2020-05-04 |
| 1972167799 | Dr Alan Napoles Dds Pllc | Dentist | 3451 S Broadway Ste B, Minot, ND 58701-7419 | 2019-04-26 |
| 1679042519 | Prairie Rose Family Dentists | Dentist | 1110 College Dr., Suite 110, Bismark, ND 58501 | 2018-11-21 |
| 1225505761 | Blake Ristvedt Dental Pllc | Dentist | 520 Main Ave Ste 705, Fargo, ND 58103-1967 | 2018-11-01 |
| 1891286977 | Jessica Rae Majidian | Dentist | 3030 49th St S, Fargo, ND 58104 | 2018-05-23 |
| 1003307182 | Arjan Majidian | Dentist | 1231 27th St S Ste B, Fargo, ND 58103-8722 | 2018-05-23 |
| 1679070163 | Nicole A Searcey | Dentist | 0005 Medical Group @ 5mdg/sgq, 194 Missile Avenue, Minot Afb, ND 58705-5024 | 2018-04-10 |
| 1114430519 | John Robert Kerr | Dentist | Quentin N. Burdick Memorial Hospital 1300 Hospital Loop, Belcourt, ND 58316 | 2017-11-08 |
| 1962930073 | Austin Michael Vetter | Dentist | 1331 32nd Ave S Ste 3, Fargo, ND 58103-5989 | 2017-06-02 |
| 1326576828 | Jeffrey James Harrie | Dentist | 3525 25th St S, Fargo, ND 58104-5900 | 2017-05-27 |
| Find all providers with the same taxonomy | ||||
| City | PARK RIVER |
| Zip Code | 58270 |
Please comment or provide details below to improve the information on PARK RIVER DENTAL, PC.
| 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.