Albertville Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ALBERTVILLE FAMILY DENTAL

Practice address

5047 Jason Ave NE
Albertville, MN 55301-9688

Phone

(763) 497-8165

Fax

(763) 497-8162

NPI assigned

Sep 23, 2020

Last updated

Sep 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patrick Gary Becicka, DDSNPI 1952469280

Title

Doctor / Owner

Phone

(763) 497-8165

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Patrick Gary Becicka, D.D.S.

  • General Practice Dentistry
  • Albertville, MN
  • NPI 1952469280
  NPD Authorized official
• Faith G Lira, DDS

  • Dentist
  • Albertville, MN
  • NPI 1629028345
  NPD (past)

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

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1033726161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5047 JASON AVE NE",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553019688",
            "telephone_number": "763-497-8165",
            "fax_number": "763-497-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5047 JASON AVE NE",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553019688",
            "telephone_number": "763-497-8165",
            "fax_number": "763-497-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERTVILLE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-23",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "BECICKA",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "DOCTOR / OWNER",
        "authorized_official_telephone_number": "763-497-8165",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Albertville - St. Michael Clinic
• Andrea Lynn Anderson, PHARM.D.
• Jennifer C Anderson, RN
• Olivia Anton
• Cassandra Antonson
• Apex Chiropractic of Albertville

• Dental Clinic/Center in Albertville, MN
• Providers in Albertville, 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 Sep 23, 2020; 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.