James Rostvold

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

JAMES ROSTVOLD

Doing business as

West Range Dental Care

Practice address

1043 E US Highway 169
Grand Rapids, MN 55744-3165

Phone

(218) 326-2560

Fax

(218) 326-8256

NPI assigned

Mar 17, 2022

Organization subpart

No

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

Authorized official

Name

Jenny Morris, LDA

Title

Front Desk

Phone

(218) 326-2560

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• West Range Dental Care Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James David Rostvold, DDS

  • Dentist
  • Grand Rapids, MN
  • NPI 1386712537
  NPD
• Kimberly Ellen Rostvold, DDS

  • Pediatric Dentistry
  • Hermantown, MN
  • NPI 1417479700
  NPD

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647475200000",
    "number": "1205584307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 339",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557440339",
            "telephone_number": "218-326-2560",
            "fax_number": "218-326-8256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1043 E US HIGHWAY 169",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443165",
            "telephone_number": "218-326-2560",
            "fax_number": "218-326-8256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES ROSTVOLD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-03-17",
        "certification_date": "2022-03-16",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "FRONT DESK",
        "authorized_official_telephone_number": "218-326-2560",
        "authorized_official_credential": "LDA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "872720100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "West Range Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; 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.