PAUL A. FREDRIKSON, D.D.S., P.C. (NPI# 1003237512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003237512 |
| Entity Type | Organization |
| Organization Name | PAUL A. FREDRIKSON, D.D.S., P.C. |
| Practice Address |
3011 25th St S Suite 1 Fargo ND 58103-6162 |
| Practice Telephone | 7012800088 |
| Practice Fax Number | 7012935602 |
| Mailing Telephone | 7012800088 |
| Mailing Fax Number | 7012935602 |
| Enumeration Date | 2013-12-31 |
| Last Update Date | 2014-01-06 |
| Authorized Official Name | PAUL A FREDRIKSON (PRESIDENT) |
| Authorized Official Telephone | 7012800088 |
| Authorized Official Credential | D.D.S., PC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
1504 | ND | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 40631 | 05 |
| Street Address |
3011 25TH ST S SUITE 1 |
| City | FARGO |
| State | ND |
| Zip Code | 58103-6162 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881075257 | Ryan Scott Nygard | Dentist | 3011 25th St S, Suite 1, Fargo, ND 58103-6162 | 2015-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1285298240 | Ann Louise Breen | Optometrist | Sanford Southpointe Eye Center & Optical, 2400 32nd Ave. S., Fargo, ND 58103 | 2019-04-25 |
| 1245706597 | Lisa Elaine Livingston | Counselor | 1337 14 and Half St. S., Fargo, ND 58103 | 2018-10-15 |
| 1528569662 | Misty Lynn Hagen | Counselor | 901 28th St. South, Suite B, Fargo, ND 58103 | 2018-02-23 |
| 1083133011 | Faith Homecare Professionals LLC | Home Health | 304 25th St S, Suite B, Fargo, ND 58103 | 2017-09-11 |
| 1982138749 | Matthew Troyer | Pharmacist | 2425 13th Ave, Fargo, ND 58103 | 2017-04-18 |
| 1801338504 | Amy Nguyen Christianson | Chiropractor | 1650 45th St S Ste 113, Fargo, ND 58103 | 2016-11-11 |
| 1245772359 | Andrea Marie Hanson | Nurse Practitioner | 2400 32nd Ave South, Fargo, ND 58103 | 2016-11-07 |
| 1831647940 | Abigail Carmen Burkett Vetter | Nurse Practitioner | 2928 University Dr S Suite 101, Fargo, ND 58103 | 2016-09-18 |
| 1013361302 | Nancy Knowlton | Speech-Language Pathologist | 3001 11th Ave S, Beyond Boundaries Speech-language, Fargo, ND 58103 | 2016-04-22 |
| Find all providers in zip 58103 | ||||
| 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 |
|---|---|---|---|---|
| 1174144851 | Robert A. Bond, D.d.s. | Dentist | 2851 University Dr S, Fargo, ND 58103-6029 | 2020-05-04 |
| 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 |
| 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 |
| 1598203606 | Krista Johnson Dmd Pllc | Dentist | 1650 45th St S Ste 108, Fargo, ND 58103-3247 | 2017-02-09 |
| 1639548118 | Nd Dentistry PC | Dentist | 1650 45th Street South, Suite 108, Fargo, ND 58104 | 2015-09-15 |
| 1497139240 | Renee Sellers | Dentist | 3633 Lincoln Street South, Fargo, ND 58104 | 2015-07-10 |
| 1669853263 | Mark A Runyan | Dentist | 100 4th St S Ste 312, Fargo, ND 58103-1937 | 2015-06-09 |
| Find all providers in FARGO | ||||
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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.