Irvin M. Galstad DDS LTD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7078 Issued in MN

Legal business name

IRVIN M. GALSTAD DDS LTD

Doing business as

Galstad Dental Clinic

Practice address

1416 Central Ave NE
East Grand Forks, MN 56721-1605

Phone

(218) 773-3004

Fax

(218) 773-3006

NPI assigned

Jul 23, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Irvin M Galstad

Title

Dentist

Phone

(218) 773-3004

Specialties & licenses 2

Addresses

Other names 1

• Galstad Dental Clinic Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374537600000",
    "number": "1003258757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 CENTRAL AVE NE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211605",
            "telephone_number": "218-773-3004",
            "fax_number": "218-773-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 CENTRAL AVE NE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211605",
            "telephone_number": "218-773-3004",
            "fax_number": "218-773-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRVIN M. GALSTAD DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-23",
        "last_updated": "2013-07-23",
        "status": "A",
        "authorized_official_last_name": "GALSTAD",
        "authorized_official_first_name": "IRVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "218-773-3004",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7078",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13228",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galstad Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anisa Danielle Holwerda, MASTER SOCIAL WORKER
• Nicholas Dean Hovde, PT
• Rhonda Laurice Huot
• Moustapha Awaleh Ibrahim
• In-Near Home Health LLC
• Lisa Jo Jamsa Tollefson, MD
• Lisa Jean Jeffrey Brown, OTR/L
• Craig Alan Johnson, DDS
• Karen Johnsonatkinson, RN
• Brady Junes, MD

• General Practice Dentistry in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.