NPIMap

Organization Active NPI

Riverside Dental-Robert C. Beattie, DDS & Associates PC

  • General Practice Dentistry
  • Princeton, MN
National Provider Identifier
1104994110
Registry record updated Jul 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7787 Issued in MN
Legal business name
RIVERSIDE DENTAL-ROBERT C. BEATTIE, DDS & ASSOCIATES PC
Practice address
404 1St St. N.
Princeton, MN 55371
Phone
(763) 389-3320
Fax
(763) 631-0662
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2008

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

Authorized official

Name
Dr. Robert C. Beattie, DDS
Title
Ceo
Phone
(763) 389-3320

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 7787 MN Primary

Addresses

Primary practice location

404 1St St. N.
Princeton, MN 55371

Mailing address

404 1St St. N.
Princeton, MN 55371
Phone (763) 389-3320

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1104994110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 1ST ST. N.",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "55371",
            "telephone_number": "763-389-3320",
            "fax_number": "763-631-0662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 1ST ST. N.",
            "city": "PRINCETON",
            "state": "MN",
            "postal_code": "55371",
            "telephone_number": "763-389-3320",
            "fax_number": "763-631-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL-ROBERT C. BEATTIE, DDS & ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "BEATTIE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "763-389-3320",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.