DAKOTA CLINIC, LTD. (NPI# 1740231182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740231182 |
| Entity Type | Organization |
| Organization Name | DAKOTA CLINIC, LTD. |
| Other Organization Name | DAKOTA CLINIC, LTD. |
| Practice Address |
1702 University Dr S Fargo ND 58103-4940 |
| Practice Telephone | 7013643300 |
| Practice Fax Number | 7013648990 |
| Mailing Telephone | 7013643300 |
| Mailing Fax Number | 7013648990 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LARRY G SOLBERG (ADMINISTRATOR-AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 7013643405 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians | ||
| X | 207L00000X | Anesthesiology | Allopathic & Osteopathic Physicians | ||
| X | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207T00000X | Neurological Surgery | Allopathic & Osteopathic Physicians | ||
| X | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| X | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| X | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| X | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| X | 207ZH0000X |
Pathology Specialization: Hematology |
Allopathic & Osteopathic Physicians | ||
| X | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| X | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| X | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| X | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ND | 10046 | 05 |
| Other Name | Type Code |
|---|---|
| Dakota Clinic, Ltd. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770537680 | Dakota Clinic, Ltd. | Family Medicine | Highway 371, Walker, MN 56484 | 2006-05-22 |
| 1245284157 | Dakota Clinic, Ltd. | Family Medicine | 212 Aspen Ave Ne, Menagha, MN 56464 | 2006-05-22 |
| 1467406181 | Dakota Clinic, Ltd. | Family Medicine | 600 Water Street E, Medina, ND 58467 | 2006-05-19 |
| 1083666176 | Dakota Clinic, Ltd. | Family Medicine | 5 9th Ave N, Casselton, ND 58012-3339 | 2006-05-17 |
| 1679525745 | Dakota Clinic, Ltd. | Family Medicine | 2710 Broadway N, Fargo, ND 58102-1408 | 2006-05-17 |
| 1043261621 | Dakota Clinic, Ltd. | Family Medicine | 2049 2nd St, Lake Park, MN 56554-4000 | 2006-05-16 |
| 1114978814 | Dakota Clinic, Ltd. | Family Medicine | 114 W Main Ave, Frazee, MN 56544-4217 | 2006-05-15 |
| 1932150646 | Dakota Clinic, Ltd. | Family Medicine | 132 4th Ave Ne, Valley City, ND 58072-3250 | 2006-05-15 |
| 1457302176 | Dakota Clinic, Ltd. | Family Medicine | 501 Main Ave S, Hankinson, ND 58041-4108 | 2006-05-15 |
| 1639120983 | Dakota Clinic, Ltd. | Family Medicine | 102 Sather Dr, Fosston, MN 56542-1531 | 2006-05-12 |
| Street Address |
1702 UNIVERSITY DR S |
| City | FARGO |
| State | ND |
| Zip Code | 58103-4940 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245223023 | Kimberly Rae Kelly | Dermatology | 1702 University Dr S, Fargo, ND 58103-4940 | 2005-08-26 |
| 1467060046 | Jessica Marie Munro | Optometrist | 1702 University Dr S, Fargo, ND 58103-4940 | 2020-07-20 |
| 1972132249 | Kalee Irene Wysuph | Student in an Organized Health Care Education/Training Program | 1702 University Dr S, Fargo, ND 58103-4940 | 2020-04-07 |
| 1699314617 | April M Sweet | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-12-23 |
| 1427603588 | Annelise Sterneman | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-08-06 |
| 1518511799 | Morgan A Schmitz | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-07-26 |
| 1093367799 | Josalyn J Grueneich | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-07-12 |
| 1295395176 | Amanda J Coronato | Occupational Therapist | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-06-13 |
| 1962976068 | Moriah M Anderson | Dietitian, Registered | 1702 University Dr S, Fargo, ND 58103-4940 | 2019-01-11 |
| 1811489743 | Karli Lenae Roman | Nurse Practitioner | 1702 University Dr S, Fargo, ND 58103-4940 | 2018-06-06 |
| Find all providers in the same location | ||||
| 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 | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750661054 | Sanford Medical Center Fargo | Oral & Maxillofacial Surgery | 801 Broadway N, Fargo, ND 58102-3641 | 2011-08-18 |
| 1245526722 | Corbett A Haas | Oral & Maxillofacial Surgery | 3000 32nd Ave S, Fargo, ND 58103 | 2011-06-23 |
| 1588962781 | William J Boggess | Oral & Maxillofacial Surgery | 1717 University Dr S, Fargo, ND 58103-4939 | 2011-03-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376650218 | Karl J Hapcic | Oral & Maxillofacial Surgery | 2252 N. Seventh St, Bismarck, ND 58501 | 2006-08-24 |
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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.