Randolph R. Pitzer DDS PC

Primary specialty

DentistTaxonomy code 122300000X

License

1628 Issued in ND

Legal business name

RANDOLPH R. PITZER DDS PC

Practice address

2224 1St Ave W
Williston, ND 58801-6286

Phone

(701) 774-0259

Fax

(701) 774-0250

NPI assigned

Nov 4, 2008

Organization subpart

Yes

Parent organization

RANDOLPH R. PITZER DDS PCAs reported in NPPES

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

Authorized official

Name

Randolph Richard Pitzer, DDS

Title

Owner Pres

Phone

(701) 774-0259

Specialties & licenses 2

Addresses

Other identifiers 1

Part of

Randolph R Pitzer DDS PC

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

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225756800000",
    "number": "1154575199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2224 1ST AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016286",
            "telephone_number": "701-774-0259",
            "fax_number": "701-774-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2224 1ST AVE W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588016286",
            "telephone_number": "701-774-0259",
            "fax_number": "701-774-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH R. PITZER DDS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RANDOLPH R. PITZER DDS PC",
        "enumeration_date": "2008-11-04",
        "last_updated": "2008-11-04",
        "status": "A",
        "authorized_official_last_name": "PITZER",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER PRES",
        "authorized_official_telephone_number": "701-774-0259",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ND",
            "license": "1628",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "ND",
            "license": "2010",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40031",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Alice Quick, LSW
• Rachelle Eldred Professional Counseling Services, PLLC
• Kerry Raghib, CNM, MSN
• June Ralph
• Yolanda Ramalho
• Hannah R Rasmussen, M.S. CCC-SLP
• Rebecca Rasmussen, O.D.
• David Rasmusson
• Mark C Raymond, MD
• Frank James Reck Jr., LAC

• Dentist in Williston, ND
• Providers in Williston, ND by specialty
• Dentist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2008; 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.