Two Harbors Family Dental, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12388 Issued in MN

Legal business name

TWO HARBORS FAMILY DENTAL, PA

Doing business as

Two Harbors Family Dental

Practice address

510 1St Ave
Two Harbors, MN 55616-1504

Phone

(218) 834-2011

Fax

(218) 834-6028

NPI assigned

Aug 2, 2016

Last updated

Aug 2, 2016By 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

Robert Benjamin Yankovich, DDSNPI 1225221039

Title

President

Phone

(218) 409-2400

Specialties & licenses 1

Addresses

Other names 1

• Two Harbors Family Dental Doing business as

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.

• Robert Benjamin Yankovich, D.D.S.

  • Dentist
  • Two Harbors, MN
  • NPI 1225221039
  NPD (past) Authorized official
• Daniel Walter Iverson, D.D.S.

  • General Practice Dentistry
  • Two Harbors, MN
  • NPI 1104990902
  NPD (past)

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470096000000",
    "number": "1104379635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 1ST AVE",
            "address_2": "PO BOX 59",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556161504",
            "telephone_number": "218-834-2011",
            "fax_number": "218-834-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 1ST AVE",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556161504",
            "telephone_number": "218-834-2011",
            "fax_number": "218-834-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWO HARBORS FAMILY DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A",
        "authorized_official_last_name": "YANKOVICH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "BENJAMIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-409-2400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Two Harbors Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• The Waterview Shores LLC
• Cory Scott Thomas, D.C.
• Evan Hans Toonstra, LGSW
• Barbara Mary Triggs, CPHT
• Paul Martin Trygstad, DDS
• Vision Pro Optical
• Laura Von Goertz, RD
• Debbie Waterhouse, RN
• Watersedge Health Center
• Waterview Shores Assisted Living LLC

• General Practice Dentistry in Two Harbors, MN
• Providers in Two Harbors, 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 Aug 2, 2016; 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.