NPIMap

Organization Active NPI

Downtown Dental GP

  • Dentist
  • Jamestown, ND
National Provider Identifier
1124405030
Registry record updated Apr 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1668 Issued in ND
Legal business name
DOWNTOWN DENTAL GP
Practice address
815 1St Ave S
Jamestown, ND 58401-4746
Phone
(701) 251-2240
NPI assigned
Apr 29, 2015
Last updated
Apr 29, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2015

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

Authorized official

Name
Dr. Kenneth Dale McDougall, DDSNPI 1407951056
Title
President
Phone
(701) 251-2240

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 1668 ND Primary

Addresses

Primary practice location

815 1St Ave S
Jamestown, ND 58401-4746

Mailing address

815 1St Ave S
Jamestown, ND 58401-4746
Phone (701) 251-2240

National Provider Directory

National Provider Directory

Locations

815 1st Ave S
Jamestown, ND 58401
Phone (701) 251-2240

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1124405030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 1ST AVE S",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584014746",
            "telephone_number": "701-251-2240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 1ST AVE S",
            "city": "JAMESTOWN",
            "state": "ND",
            "postal_code": "584014746",
            "telephone_number": "701-251-2240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOWNTOWN DENTAL GP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "MCDOUGALL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-251-2240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ND",
            "license": "1668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.