Dakota Spine and Sport

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

856 Issued in ND

Legal business name

DAKOTA SPINE AND SPORT

Practice address

300 45TH St S
#315
Fargo, ND 58103-1189

Phone

(701) 893-7877

NPI assigned

Mar 15, 2010

Last updated

Jul 2, 2010By 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

Leighton Mohl, D.C.

Title

President

Phone

(701) 318-4928

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278028800000",
    "number": "1205150612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2722 33 1/2 AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 45TH ST S",
            "address_2": "#315",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031189",
            "telephone_number": "701-893-7877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA SPINE AND SPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-07-02",
        "status": "A",
        "authorized_official_last_name": "MOHL",
        "authorized_official_first_name": "LEIGHTON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "701-318-4928",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dakota Pediatric Dentistry
• Dakota Pediatric Dentistry Partnership (Dakota Pediatric Dentistry)
• Dakota Pediatric Gastroenterology
• Dakota Smiles, PLLC
• Dakota Specialty Institute (Innovis Health)
• Danilo Antonio Dalan, MD
• Andrew Lee Dalberg
• Cassandra Vanasse Dale, MSW, LCSW
• Megan Maria Dallman, CRNA
• Damen Pathway Health Wheels

• Chiropractor in Fargo, ND
• Providers in Fargo, ND by specialty
• Chiropractor in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2010; 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.