Daniel Jeffrey Fordice, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13876 Issued in MN

Practice address

1120 Birch St
Fairmont, MN 56031-4418

Phone

(507) 236-4276

NPI assigned

Mar 1, 2017

Sex

Male

Sole proprietor

Yes

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Santa Barbara Neighborhood Clinics

  • Federally Qualified Health Center (FQHC)
  • Santa Barbara, CA
  • NPI 1063438232
  NPD (past)
• Santa Barbara Neighborhood Clinics

  • Dental Clinic/Center
  • Santa Barbara, CA
  • NPI 1972636835
  NPD (past)

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1144760737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 SILVER LAKE DR",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560315081",
            "telephone_number": "218-341-8545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 BIRCH ST",
            "city": "FAIRMONT",
            "state": "MN",
            "postal_code": "560314418",
            "telephone_number": "507-236-4276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "923 N Milpas St",
            "address_purpose": "LOCATION",
            "city": "Santa Barbara",
            "state": "CA",
            "postal_code": "931032331",
            "country_code": "US",
            "telephone_number": "805-884-1998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORDICE",
        "first_name": "DANIEL",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-03-01",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fairmont Orthopedics & Sports Medicine, PA
• Fairmont Orthopedics & Sports Medicine, PA
• Samantha Augusta Farnum, APRN
• Robert Fernandez, MD
• Five Lakes Dental Studio LLC
• Jeffrey Howard Fordice, DDS
• Taylor Forstner, DDS
• Amanda J Forstrom, PT
• Robert Friese, OD
• Michelle Larae Geerdes, OTR/L

• General Practice Dentistry in Fairmont, MN
• Providers in Fairmont, 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 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.