Blake Ristvedt Dental PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BLAKE RISTVEDT DENTAL PLLC

Practice address

520 Main Ave Ste 705
Fargo, ND 58103-1967

Phone

(701) 237-4341

Fax

(701) 297-5938

NPI assigned

Nov 1, 2018

Last updated

Nov 1, 2018By 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

Blake E Ristvedt, DDS

Title

Owner

Phone

(701) 866-3676

Specialties & licenses 1

Addresses

Locations

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.

• Ronald Paul McClure, DDS

  • General Practice Dentistry
  • Fargo, ND
  • NPI 1215925276
  NPD (past)

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

{
    "created_epoch": "1541030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541030400000",
    "number": "1225505761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 MAIN AVE STE 705",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031967",
            "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 STE 705",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031967",
            "telephone_number": "701-237-4341",
            "fax_number": "701-297-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAKE RISTVEDT DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-01",
        "last_updated": "2018-11-01",
        "status": "A",
        "authorized_official_last_name": "RISTVEDT",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-866-3676",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Elaine Bjur, LMFT
• Angela Stephanie Blackford, LBSW
• Richard W Blaine, MD
• Karan Blair
• Jennifer Blais, APRN, CNP
• Michael Blake, MS, RD, LRD
• Amy Rose Blakeway
• Miran Joel Blanchard, MD
• Stephane Robert Leo Blanchard, M.D.
• Janelle Joy Blanchet

• 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 Nov 1, 2018; 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.