Northern Lakes Dental - Riverfront, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

NORTHERN LAKES DENTAL - RIVERFRONT, LLC

Practice address

124 E Lincoln Ave
Fergus Falls, MN 56537-2217

Phone

(218) 736-5627

Fax

(218) 736-6955

NPI assigned

Dec 5, 2019

Organization subpart

No

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

Authorized official

Name

Catie Sue Baglo

Title

Administrative Assistant

Phone

(218) 736-4000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1575504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1575504000000",
    "number": "1013554310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 WESTERN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565374808",
            "telephone_number": "218-736-4000",
            "fax_number": "218-736-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E LINCOLN AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372217",
            "telephone_number": "218-736-5627",
            "fax_number": "218-736-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LAKES DENTAL - RIVERFRONT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-05",
        "last_updated": "2019-12-05",
        "status": "A",
        "authorized_official_last_name": "BAGLO",
        "authorized_official_first_name": "CATIE",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "ADMINISTRATIVE ASSISTANT",
        "authorized_official_telephone_number": "218-736-4000"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Newton, RPH
• Wendy Ann Nickolauson, LPN
• Charis Helen Nielsen, RN
• Dennis D. Nims, MSW
• Kristy Norenberg, MPH, RD
• Northern Lakes Dental, LTD.
• Northern Lights Psychological Services P.a.
• Robert S Noyes, MD
• Tanner Nygaard
• Jerra Cori Nylund

• Dental Clinic/Center in Fergus Falls, MN
• Providers in Fergus Falls, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2019; 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.