Dodson Directive, P.a.

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

52435 Issued in MN

Legal business name

DODSON DIRECTIVE, P.A.

Practice address

810 Lilac Dr N
Ste B
Golden Valley, MN 55422

Phone

(651) 315-2192

Fax

(763) 522-2222

NPI assigned

Mar 27, 2015

Organization subpart

No

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

Authorized official

Name

Dr. David Kirk Dodson, M.D.

Title

Director

Phone

(651) 315-2192

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1427414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427414400000",
    "number": "1245624246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 LILAC DR N",
            "address_2": "SUITE B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224656",
            "telephone_number": "651-315-2192",
            "fax_number": "763-522-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 LILAC DR N",
            "address_2": "STE B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "651-315-2192",
            "fax_number": "763-522-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DODSON DIRECTIVE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-27",
        "last_updated": "2015-03-27",
        "status": "A",
        "authorized_official_last_name": "DODSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "KIRK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "651-315-2192",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MN",
            "license": "52435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Substance Use Disorder Rehabilitation Clinic/Center in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; 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.