Clearbrook Dental Clinic, LTD

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

10180 Issued in MN

Legal business name

CLEARBROOK DENTAL CLINIC, LTD

Practice address

113 Main St S
Clearbrook, MN 56634-0314

Phone

(218) 776-3558

Fax

(218) 776-2112

NPI assigned

Oct 12, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randy Carl Beard, D.D.S.NPI 1447349535

Title

Owner

Phone

(218) 776-3558

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Randy Carl Beard, D.D.S.

  • General Practice Dentistry
  • Clearbrook, MN
  • NPI 1447349535
  NPD (past) Authorized official

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164511267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 MAIN ST S",
            "city": "CLEARBROOK",
            "state": "MN",
            "postal_code": "566340314",
            "telephone_number": "218-776-3558",
            "fax_number": "218-776-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 MAIN ST S",
            "city": "CLEARBROOK",
            "state": "MN",
            "postal_code": "566340314",
            "telephone_number": "218-776-3558",
            "fax_number": "218-776-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARBROOK DENTAL CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEARD",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-776-3558",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "10180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B&D Mobility, Inc.
• Randy Carl Beard, D.D.S.
• Amy M Beckstrand, M.T.
• Nancy Campbell, REGISTERED NURSE
• Clear Waters Life Center
• Clearbrook-Gonvick Isd #2311
• Clearwater County Memorial Hospital (Clearwater Health Services Clinic)
• Roxanne Engebretson, REGISTERED NURSE
• Sheila Erickson, REGISTERED NURSE
• Wendy Kay Glass, REGISTERED NURSE

• Dental Clinic/Center in Clearbrook, MN
• Providers in Clearbrook, MN by specialty
• Dental Clinic/Center in Minnesota

• 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.

Verify at the official NPI Registry.