CHARLES A CRAGO (NPI# 1629147723) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629147723 |
| Entity Type | Individual |
| Full Name | CHARLES A CRAGO |
| Credential | DMD, MD |
| Practice Address |
4344 20th Ave S Suite 2 Fargo ND 58103-7436 |
| Practice Telephone | 7012395969 |
| Practice Fax Number | 7012390034 |
| Mailing Telephone | 7012395969 |
| Mailing Fax Number | 7012390034 |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2010-12-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
1927 | ND | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | DENTAL LICENSE | 1927 | 01 |
| ND | 41302 | 05 |
| Street Address |
4344 20TH AVE S SUITE 2 |
| City | FARGO |
| State | ND |
| Zip Code | 58103-7436 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487747267 | Steven M Bagan | Ophthalmology | 4344 20th Ave S, Fargo, ND 58103-4434 | 2006-10-02 |
| 1437558608 | Slenderlite, LLC | Clinic/Center | 4344 20th Ave S, Fargo, ND 58103-7436 | 2014-08-14 |
| 1053604397 | Matthew T Sanders | Optometrist | 4344 20th Ave S, # 1, Fargo, ND 58103-7436 | 2011-05-19 |
| 1477872034 | Vision Optical LLC | Eyewear Supplier (Equipment, not the service) | 4344 20th Ave S, Fargo, ND 58103-7436 | 2010-05-21 |
| 1275862344 | Steven M Bagan, Md PC | Ophthalmology | 4344 20th Ave S, Fargo, ND 58103-7436 | 2009-12-18 |
| 1750616835 | Sarah Swanholm | Optometrist | 4344 20th Ave S, Fargo, ND 58103-7436 | 2009-10-07 |
| 1508048521 | Jonathan Russell Gray | Dentist | 4344 20th Ave S, Fargo, ND 58103-7436 | 2007-11-30 |
| 1114047230 | Laser & Surgery Center, LLC | Clinic/Center | 4344 20th Ave S, Fargo, ND 58103-4434 | 2007-03-30 |
| 1295804300 | Face and Jaw Surgeons PC | Dentist | 4344 20th Ave S, Ste 2, Fargo, ND 58103-7436 | 2006-11-06 |
| 1780761031 | Scott A Preisler | Dentist | 4344 20th Ave S, Suite 2, Fargo, ND 58103-7436 | 2006-11-01 |
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| 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 | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538147848 | Michael J Noffze | Dentist | 2856 Brandt Dr S, Fargo, ND 58104-8805 | 2006-01-06 |
| 1295739233 | Edward Francis May | Dentist | 2585 23rd Ave S, Ste A., Fargo, ND 58103 | 2005-06-08 |
| 1720241615 | Martin Belanger | Dentist | 1720 University Dr S, Fargo, ND 58103-4940 | 2008-07-09 |
| 1508048521 | Jonathan Russell Gray | Dentist | 4344 20th Ave S, Fargo, ND 58103-7436 | 2007-11-30 |
| 1295804300 | Face and Jaw Surgeons PC | Dentist | 4344 20th Ave S, Ste 2, Fargo, ND 58103-7436 | 2006-11-06 |
| 1780761031 | Scott A Preisler | Dentist | 4344 20th Ave S, Suite 2, Fargo, ND 58103-7436 | 2006-11-01 |
| 1467487298 | Paul H Iverson | Dentist | 1702 University Dr S, Fargo, ND 58103-4940 | 2006-07-11 |
| 1225013022 | Karel A Deleeuw | Dentist | 1717 University Dr S, Fargo, ND 58103 | 2005-12-14 |
| 1598763120 | Prairie Oral Surgery | Dentist | 2585 23rd Ave S, Ste A., Fargo, ND 58103 | 2005-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396343737 | Face and Jaw Surgeons PC | Dentist | 1517 12 Ave Ne, Jamestown, ND 58401 | 2020-10-16 |
| 1649816828 | Dr. Jeremiah J. Glosenger, PC | Dentist | 2615 Elk Dr Ste 3, Minot, ND 58701-1200 | 2019-11-21 |
| 1255759650 | Implant&maxillofacial Surgical Center | Dentist | 2224 1st Ave W Ste 2, Williston, ND 58801-6286 | 2014-04-02 |
| 1477723591 | Oral Surgery Center of Bismarck, PC | Dentist | 3117 N 14th St, Bismarck, ND 58503-0664 | 2008-03-04 |
| 1457420564 | Face and Jaw Surgeons PC | Dentist | 2845 36 Ave South, Grand Forks, ND 58201-6747 | 2006-11-06 |
| 1073697157 | Troy R Petersen | Dentist | 1165c South Columbia Road, Grand Forks, ND 58201-4007 | 2006-10-25 |
| 1790889152 | Rudy J Schneider | Dentist | 3187 Blue Stem Dr Ste 4, West Fargo, ND 58078-8008 | 2006-09-07 |
| 1588697015 | Phillip T. Iero, M.d.,d.d.s., PC | Dentist | 416 N 6th St, Bismarck, ND 58501-4416 | 2006-07-08 |
| 1285670067 | John G Stanley | Dentist | 2331 Tyler Pkwy, Suite 4, Bismarck, ND 58503-0871 | 2006-06-21 |
| 1184667305 | Face and Jaw Surgeons PC | Dentist | 1140 W Capitol Ave, Bismarck, ND 58501-9956 | 2006-06-14 |
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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.