Daniel Walter Iverson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8592 Issued in MN

Practice address

510 1St Ave
Two Harbors, MN 55616-1504

Phone

(218) 834-2011

Fax

(218) 834-6028

NPI assigned

Nov 20, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Two Harbors Family Dental, PA

  dba Two Harbors Family Dental

  • General Practice Dentistry
  • Two Harbors, MN
  • NPI 1104379635
  NPD (past)

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104990902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 1ST AVE",
            "address_2": "P.O. 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": {
        "last_name": "IVERSON",
        "first_name": "DANIEL",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa J Hastings, RPH, PHARMD
• Healing Collective
• Sharon Ann Hellman
• Lucas Thor Henningsen, MD
• Nicole Anne Humes, RDH
• Elaine Mae Jackson
• Alexis Nicole Jacobson, LICSW
• Jane Wolf Speech and Feeding Therapy LLC
• John W. Pepelnjak Chiropractic Clinic, Inc.
• Tracy Jones, PHARMD

• 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 Jul 8, 2007; 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.