Paul John Stark, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D8559 Issued in MN

Practice address

508 S. Main St.
Biwabik, MN 55708

Phone

(218) 865-4131

Fax

(218) 865-4131

NPI assigned

Oct 11, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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.

• Biwabik Family Dental, PA

  • General Practice Dentistry
  • Biwabik, MN
  • NPI 1356870117
  NPD (past)

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144319161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 S 1ST ST E",
            "city": "AURORA",
            "state": "MN",
            "postal_code": "557051501",
            "telephone_number": "218-229-2741",
            "fax_number": "218-229-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 S. MAIN ST.",
            "city": "BIWABIK",
            "state": "MN",
            "postal_code": "55708",
            "telephone_number": "218-865-4131",
            "fax_number": "218-865-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "PAUL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D8559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Biwabik Family Dental, PA
• City of Biwabik (Biwabik Fire Department Ambulance)
• Mindfully Blessed LLC
• Jerald Mitchell

• General Practice Dentistry in Biwabik, MN
• Providers in Biwabik, 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.