Elbow Lake Dental Center, Inc.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8946 Issued in MN

Legal business name

ELBOW LAKE DENTAL CENTER, INC.

Practice address

18 Division St W
PO 1032
Elbow Lake, MN 56531

Phone

(218) 685-4710

Fax

(218) 685-6837

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Orvin Jacob Leis, DDSNPI 1417021858

Title

President

Phone

(218) 685-4710

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.

• Orvin Jacob Leis, DDS

  • General Practice Dentistry
  • Elbow Lake, MN
  • NPI 1417021858
  NPD (past) Authorized official

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205904513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1032",
            "address_2": "18 DIVISION ST W",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "56531",
            "telephone_number": "218-685-4710",
            "fax_number": "218-685-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 DIVISION ST W",
            "address_2": "PO 1032",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "56531",
            "telephone_number": "218-685-4710",
            "fax_number": "218-685-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELBOW LAKE DENTAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LEIS",
        "authorized_official_first_name": "ORVIN",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-685-4710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Walter Anderson, EDD, LMHC, LPCC, LAD
• Susan Marie Berg, PA-C
• Elbow Lake Dentistry, PLLC
• Eleah Medical Center
• Grant County Social Services
• Grant County Transportation
• Pamla Sandra Greiner, RN, CNP

• General Practice Dentistry in Elbow Lake, MN
• Providers in Elbow Lake, 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 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.