Ronald Paul McClure, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1487 Issued in ND

Practice address

520 Main Ave
Suite 705
Fargo, ND 58103-1971

Phone

(701) 237-4341

Fax

(701) 297-5938

NPI assigned

Oct 12, 2005

Last updated

Jun 3, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blake Ristvedt Dental PLLC

  • General Practice Dentistry
  • Fargo, ND
  • NPI 1225505761
  NPD (past)

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1215925276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MAIN AVE",
            "address_2": "SUITE 705",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031971",
            "telephone_number": "701-237-4341",
            "fax_number": "701-297-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 MAIN AVE",
            "address_2": "SUITE 705",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031971",
            "telephone_number": "701-237-4341",
            "fax_number": "701-297-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "RONALD",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40485",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/DSC",
            "identifier": "901487",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica McClaflin, LAPC
• Kaitlyn McClaflin, PT, DPT
• Kami McClaflin
• Nadine R McClaskey, RT (R) (M) (CT)
• Tanith McCloud
• Michael McClusky
• Anthony Michael McConnon
• Elizabeth Debra McCormack, ATC
• Kelly Jeanne McCormick, LAC
• Samson McCoy

• General Practice Dentistry in Fargo, ND
• Providers in Fargo, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.