NPIMap

Organization Active NPI

Park Rapids Family Dental PLLC

  • General Practice Dentistry
  • Park Rapids, MN
National Provider Identifier
1033739248
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
PARK RAPIDS FAMILY DENTAL PLLC
Practice address
19033 US 71
Park Rapids, MN 56470-3202
Phone
(218) 732-3291
Fax
(218) 237-2532
NPI assigned
Apr 17, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Authorized official

Name
Dr. Lora L Nelson, DDSNPI 1851658793
Title
Owner/Dentist
Phone
(763) 639-1291

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
Dental Clinic/Center 261QD0000X

Addresses

Primary practice location

19033 US 71
Park Rapids, MN 56470-3202

Mailing address

19201 Eastbay Dr
Park Rapids, MN 56470-6219
Phone (763) 639-1291

National Provider Directory

National Provider Directory

Locations

19033 US 71
Park Rapids, MN 56470
Phone (218) 732-3291

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587427200000",
    "number": "1033739248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19201 EASTBAY DR",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564706219",
            "telephone_number": "763-639-1291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19033 US 71",
            "city": "PARK RAPIDS",
            "state": "MN",
            "postal_code": "564703202",
            "telephone_number": "218-732-3291",
            "fax_number": "218-237-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK RAPIDS FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-17",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "LORA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "763-639-1291",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.