Excelsior Dental Care

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

9105 Issued in MN

Legal business name

EXCELSIOR DENTAL CARE

Practice address

7814 Excelsior Rd
Baxter, MN 56425-8427

Phone

(218) 829-8863

Fax

(218) 829-8863

NPI assigned

Oct 23, 2013

Organization subpart

No

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

Authorized official

Name

Stacy Hillman

Title

Front Desk Manager

Phone

(218) 829-8863

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clark D Zard, DDS

  • Dentist
  • Baxter, MN
  • NPI 1407814445
  NPD (past)

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1124456421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7814 EXCELSIOR RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258427",
            "telephone_number": "218-829-8863",
            "fax_number": "218-829-8863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7814 EXCELSIOR RD",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258427",
            "telephone_number": "218-829-8863",
            "fax_number": "218-829-8863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELSIOR DENTAL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "HILLMAN",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "FRONT DESK MANAGER",
        "authorized_official_telephone_number": "218-829-8863"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "MN",
            "license": "9105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Elise Engen
• Deborah Anna Erickson, MA MFT
• Wayne C Erickson, PT
• Alysia Sue Eschenbacher, DC
• John Evenocheck
• Sophia Jane Exsted, AA
• Sarah Nicole Fairbanks
• Matthew Falk, PHARM.D.
• Shannon Fanth
• Emily Marie Faust

• Point of Service in Baxter, MN
• Providers in Baxter, MN by specialty
• Point of Service in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2013; 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.