Active NPI
Kittson Dental Clinic PA
- Dentist
- Hallock, MN
National Provider Identifier
1144303256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D12024
- Legal business name
- KITTSON DENTAL CLINIC PA
- Practice address
- 1010 South Birch
Hallock, MN 56728 - Phone
- (218) 843-3343
- Fax
- (218) 843-8053
- NPI assigned
- Oct 23, 2006
- Last updated
- Aug 22, 2020
- 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
- Dr. Travis Ammen Hanel, DDS
- Title
- Owner Only Shareholder
- Phone
- (218) 843-3343
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D12024 | MN | Primary |
Addresses
Primary practice location
1010 South Birch
Hallock, MN 56728
Mailing address
1010 South Birch
Hallock, MN 56728
Phone (218) 843-3343
National Provider Directory
National Provider Directory- Tax ID family
- Kittson Dental Clinic PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Warren, MN
- NPI 1053739698
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Exclusive Provider Organization
- Warren, MN
- NPI 1447583778
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1144303256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 SOUTH BIRCH",
"city": "HALLOCK",
"state": "MN",
"postal_code": "56728",
"telephone_number": "218-843-3343",
"fax_number": "218-843-8053"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 SOUTH BIRCH",
"city": "HALLOCK",
"state": "MN",
"postal_code": "56728",
"telephone_number": "218-843-3343",
"fax_number": "218-843-8053"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KITTSON DENTAL CLINIC PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-23",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "HANEL",
"authorized_official_first_name": "TRAVIS",
"authorized_official_middle_name": "AMMEN",
"authorized_official_title_or_position": "OWNER ONLY SHAREHOLDER",
"authorized_official_telephone_number": "218-843-3343",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MN",
"license": "D12024",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hallock, MN
- Jeremy Anderson
- Kristin Marie Atwood, OD
- Julie A. J. Johnson, FNP
- Kittson Central School District #2171
- Kittson County
- Kittson Memorial Hospital Association
- Kittson Memorial Hospital Association (Kittson Memorial Healthcare Center)
- Kittson Memorial Hospital Association (River's Edge)
- Kittson Memorial Hospital Association (Kittson Healthcare)
- Kittson Memorial Hospital Association (Kittson Pharmacy)
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.