Active NPI
Dakota Clinic, LTD.
- Family Medicine Physician
- Detroit Lakes, MN
National Provider Identifier
1104877455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- DAKOTA CLINIC, LTD.
- Practice address
- 125 Frazee St E
Detroit Lakes, MN 56501-3501 - Phone
- (218) 844-2300
- Fax
- (218) 844-2444
- NPI assigned
- May 12, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Larry G Solberg
- Title
- Administrator-Authorized Official
- Phone
- (701) 364-3405
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
125 Frazee St E
Detroit Lakes, MN 56501-3501
Mailing address
PO Box 727
Detroit Lakes, MN 56502-0727
Phone (218) 844-2300
Other names 1
- Dakota Clinic, Ltd. - Detroit Lakes
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147392000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1104877455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 727",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565020727",
"telephone_number": "218-844-2300",
"fax_number": "218-844-2444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 FRAZEE ST E",
"city": "DETROIT LAKES",
"state": "MN",
"postal_code": "565013501",
"telephone_number": "218-844-2300",
"fax_number": "218-844-2444"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DAKOTA CLINIC, LTD.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-12",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "SOLBERG",
"authorized_official_first_name": "LARRY",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "ADMINISTRATOR-AUTHORIZED OFFICIAL",
"authorized_official_telephone_number": "701-364-3405"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Dakota Clinic, Ltd. - Detroit Lakes",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Detroit Lakes, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.