Biwabik Family Dental, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11822 Issued in MN

Legal business name

BIWABIK FAMILY DENTAL, PA

Practice address

508 Main St. South
Biwabik, MN 55708

Phone

(218) 865-4131

NPI assigned

Jun 6, 2017

Last updated

Jun 6, 2017By 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

Steven Bakke, DDS

Title

Dentist

Phone

(218) 865-4131

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, and the practitioner matching its NPPES authorized official.

• Paul John Stark, DDS

  • General Practice Dentistry
  • Biwabik, MN
  • NPI 1144319161
  NPD (past)

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496707200000",
    "number": "1356870117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 549",
            "address_2": "508 MAIN ST. SOUTH",
            "city": "BIWABIK",
            "state": "MN",
            "postal_code": "55708",
            "telephone_number": "218-865-4131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 MAIN ST. SOUTH",
            "city": "BIWABIK",
            "state": "MN",
            "postal_code": "55708",
            "telephone_number": "218-865-4131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIWABIK FAMILY DENTAL, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2017-06-06",
        "status": "A",
        "authorized_official_last_name": "BAKKE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "218-865-4131",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Biwabik (Biwabik Fire Department Ambulance)
• Mindfully Blessed LLC
• Jerald Mitchell
• Paul John Stark, DDS

• General Practice Dentistry in Biwabik, MN
• Providers in Biwabik, 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 Jun 6, 2017; 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.