NPIMap

Organization Active NPI

Dr Duane Krivarchka, DDS, PC

  • Dental Clinic/Center
  • Lisbon, ND
National Provider Identifier
1275944407
Registry record updated May 9, 2014
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Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
1677 Issued in ND
Legal business name
DR DUANE KRIVARCHKA, DDS, PC
Practice address
11 11TH Ave W
Lisbon, ND 58054
Phone
(701) 683-4455
NPI assigned
May 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2014

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

Authorized official

Name
Heather Bergemann
Title
Office Manager
Phone
(701) 683-4455

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 1677 ND Primary

Addresses

Primary practice location

11 11TH Ave W
Lisbon, ND 58054

Mailing address

PO Box 233
11 11TH Ave W
Lisbon, ND 58054
Phone (701) 683-4455

Other identifiers 1

IdentifierTypeStateIssuer
40908MedicaidND

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1275944407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 233",
            "address_2": "11 11TH AVE W",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "58054",
            "telephone_number": "701-683-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 11TH AVE W",
            "city": "LISBON",
            "state": "ND",
            "postal_code": "58054",
            "telephone_number": "701-683-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DUANE KRIVARCHKA, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-09",
        "last_updated": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "BERGEMANN",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "701-683-4455"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ND",
            "license": "1677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40908",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisbon, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.