SPIRIT LAKE TRIBE (NPI# 1508317090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508317090 |
| Entity Type | Organization |
| Organization Name | SPIRIT LAKE TRIBE |
| Other Organization Name | SPIRIT LAKE HEALTH CENTER |
| Practice Address |
3883 74th Ave Ne Fort Totten ND 58335 |
| Mailing Address |
Po Box 309 Fort Totten ND 58335-0309 |
| Practice Telephone | 7017661600 |
| Practice Fax Number | 7017661630 |
| Mailing Telephone | 7017661600 |
| Mailing Fax Number | 7017661630 |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |
| Authorized Official Name | MICHELLE BELT (CEO) |
| Authorized Official Telephone | 7017661600 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPIRIT LAKE TRIBE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Spirit Lake Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053515783 | Spirit Lake Tribe | Ambulance | 1403 Brunswick Ave, Fort Totten, ND 58335-0449 | 2007-06-14 |
| 1720152457 | Spirit Lake Tribe | Case Management | 416 2nd Avenue North, Fort Totten, ND 58335 | 2006-11-17 |
| 1740387059 | Spirit Lake Tribe | Ambulance | 7686 Ephriam Hill Road, Fort Totten, ND 58335 | 2006-09-20 |
| 1821622010 | Spirit Lake Tribe | Non-emergency Medical Transport (VAN) | 3883 74th Ave Ne, Fort Totten, ND 58335-0309 | 2020-02-26 |
| 1225576341 | Spirit Lake Tribe | Internal Medicine | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-02-09 |
| 1417408907 | Spirit Lake Tribe | Optometrist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1144771650 | Spirit Lake Tribe | Social Worker | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1609327196 | Spirit Lake Tribe | Psychiatry & Neurology | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1912458407 | Spirit Lake Tribe | Radiology | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| 1063963551 | Spirit Lake Tribe | Physician Assistant | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2016-10-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | SPIRIT LAKE TRIBE | 816 3 Ave N, Fort Totten, ND 58335-9998 |
| Street Address |
3883 74TH AVE NE |
| City | FORT TOTTEN |
| State | ND |
| Zip Code | 58335 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124646146 | Liza A Ystaas | Nurse Practitioner | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2020-07-07 |
| 1205453172 | Mikkel Elizabeth Buckmier | Nurse Practitioner | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2020-06-26 |
| 1821622010 | Spirit Lake Tribe | Non-emergency Medical Transport (VAN) | 3883 74th Ave Ne, Fort Totten, ND 58335-0309 | 2020-02-26 |
| 1144874108 | Sarah Ruth Cavanaugh | Dentist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2019-07-29 |
| 1629508452 | Jacqueline Patrice Schroeder | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335-5833 | 2017-06-14 |
| 1831629732 | Ashley Storbakken | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-14 |
| 1740710649 | Kyla Sarah Delorme | Registered Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-14 |
| 1386174316 | Chelsea Rose Young | Licensed Practical Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-13 |
| 1518496207 | Angela I Cross | Licensed Practical Nurse | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-06-07 |
| 1225576341 | Spirit Lake Tribe | Internal Medicine | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2017-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356941116 | Sherry Yvonne Longie | Technician | 213 Dakotah Dr. #53, Fort Totten, ND 58335 | 2020-10-29 |
| 1235650250 | Tiffaney Anne Two Eagle | Registered Nurse | 3883 74th Avenue Northeast, Fort Totten, ND 58335 | 2017-06-29 |
| 1093015265 | Spirit Lake Head Start | Clinic/Center | 816 3rd Ave North, Fort Totten, ND 58335 | 2010-10-22 |
| 1154532000 | Nancy C Dauphinais | Technician, Pathology | 3883 74th Avenue North East, Fort Totten, ND 58335 | 2007-05-24 |
| 1467575159 | Jeanette Lucille Rosenheim | Registered Nurse | Spirit Lake Health Center, 3883 74th Ave Ne Box 309, Fort Totten, ND 58335 | 2007-04-09 |
| 1184744518 | Tammy Delaine Lawrence | Registered Nurse | 3883 74th Avenue Ne, Fort Totten, ND 58335 | 2007-03-30 |
| 1821127036 | Evangeline S. Gaid | Family Medicine | 3883 74th Ave.ne, Ft. Totten, ND 58335 | 2007-03-05 |
| 1538296199 | Cheri J Schaffer | Registered Nurse | 3883 74th Ave North East, Fort Totten, ND 58335 | 2007-02-28 |
| 1720152457 | Spirit Lake Tribe | Case Management | 416 2nd Avenue North, Fort Totten, ND 58335 | 2006-11-17 |
| 1740387059 | Spirit Lake Tribe | Ambulance | 7686 Ephriam Hill Road, Fort Totten, ND 58335 | 2006-09-20 |
| Find all providers in zip 58335 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144874108 | Sarah Ruth Cavanaugh | Dentist | 3883 74th Ave Ne, Fort Totten, ND 58335 | 2019-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598373581 | Jordan Brummond | Dentist | 4204 Boulder Ridge Rd Ste 140, Bismarck, ND 58503-6162 | 2020-07-16 |
| 1659924843 | Amanda Hericks | Dentist | 1338 Gateway Drive S, Fargo, ND 58103 | 2019-07-17 |
| 1457812836 | Anna Kay Coyne | Dentist | 1300 E Lasalle Dr, Bismarck, ND 58503-5716 | 2019-03-27 |
| 1851879738 | Navneet Kaur Grewal | Dentist | 3300 32nd Ave S Ste 103, Grand Forks, ND 58201-5803 | 2018-08-01 |
| 1124513668 | Casey Alexander Mclachlan | Dentist | 1383 21st Ave N Ste B, Fargo, ND 58102-1841 | 2018-06-27 |
| 1104317189 | Paul Benedict Dusek | Dentist | 321 Briggs Ave S Ste 3, Park River, ND 58270 | 2018-05-24 |
| 1033617238 | Saving Smiles Denistry | Dentist | 3210 18th St S Ste B, Fargo, ND 58104-6789 | 2018-01-23 |
| 1790297430 | Northern Lights Dental | Dentist | 4150 19th Ave S, Suite 301, Fargo, ND 58104 | 2017-11-03 |
| 1316483050 | Liebold Dental Pllc | Dentist | 210 11th St E, Bottineau, ND 58318-2052 | 2017-01-18 |
| 1689117830 | Prairie Rose Family Dentists | Dentist | 900 E Calgary Ave, Bismarck, ND 58503-5616 | 2016-11-21 |
| Find all providers with the same taxonomy | ||||
| City | FORT TOTTEN |
| Zip Code | 58335 |
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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.