Organization Active NPI

Day Dental PC

  • Dental Clinic/Center
  • Fargo, ND
National Provider Identifier
1184210544
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DAY DENTAL PC
Practice address
5120 Prosperity Way S Ste 108
Fargo, ND 58104-7568
Phone
(701) 888-9222
NPI assigned
Dec 18, 2020
Last updated
Dec 18, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Authorized official

Name
Mr. Kelly Johnson
Title
Business Manager
Phone
(701) 888-9222

Specialties & licenses 1

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

Addresses

Primary practice location

5120 Prosperity Way S Ste 108
Fargo, ND 58104-7568

Mailing address

5120 Prosperity Way S Ste 108
Fargo, ND 58104-7568
Phone (701) 888-9222

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address info@daydentalfargo.com Direct

National Provider Directory

National Provider Directory

Locations

5120 Prosperity Way S
Ste 108
Fargo, ND 58104
Phone (701) 888-9222

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": "1608249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608249600000",
    "number": "1184210544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 PROSPERITY WAY S STE 108",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047568",
            "telephone_number": "701-888-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 PROSPERITY WAY S STE 108",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047568",
            "telephone_number": "701-888-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "701-888-9222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@daydentalfargo.com",
            "affiliation": "N",
            "endpointDescription": "AES 256 Encryption",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "5120 Prosperity Way S Ste 108",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581047568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.