NPIMap

Organization Active NPI

Center for Smile Design, LTD

  • Dental Clinic/Center
  • Grand Forks, ND
National Provider Identifier
1184009839
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
1635 Issued in ND
Legal business name
CENTER FOR SMILE DESIGN, LTD
Practice address
117 N Washington St
Grand Forks, ND 58203-3450
Phone
(701) 746-1481
Fax
(701) 746-6201
NPI assigned
Jul 23, 2015
Last updated
Jul 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Dr. James O'Connell, DDSNPI 1699879213
Title
President
Phone
(701) 746-1481

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 1635 ND Primary

Addresses

Primary practice location

117 N Washington St
Grand Forks, ND 58203-3450

Mailing address

117 N Washington St
Grand Forks, ND 58203-3450
Phone (701) 746-1481

Other identifiers 4

IdentifierTypeStateIssuer
41259MedicaidND
000719850OtherUNITED CONCORDIA
1635OtherDELTA DENTAL
1635OtherNDBLUE CROSS BLUE SHIELD OF ND

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1184009839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 N WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582033450",
            "telephone_number": "701-746-1481",
            "fax_number": "701-746-6201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 N WASHINGTON ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582033450",
            "telephone_number": "701-746-1481",
            "fax_number": "701-746-6201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR SMILE DESIGN, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-23",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "O'CONNELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-746-1481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ND",
            "license": "1635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41259",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "000719850",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "1635",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF ND",
            "identifier": "1635",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; 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.