Northern Dental Partners and Associates PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

NORTHERN DENTAL PARTNERS AND ASSOCIATES PLLC

Doing business as

Miskovich Dental Clinic

Practice address

1121 SE 4TH Ave
Grand Rapids, MN 55744-3956

Phone

(218) 326-3437

Fax

(218) 327-1211

NPI assigned

Jan 20, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Peter John Miskovich, DDSNPI 1780759944

Title

Dentist/Partner

Phone

(218) 326-3437

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Miskovich Dental Clinic Doing business as

Practitioners 4

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.

• Peter J Miskovich, DDS

  • General Practice Dentistry
  • Grand Rapids, MN
  • NPI 1780759944
  NPD (past) Authorized official
• Christina Marie Hubred, A D.T., DH

  • Advanced Practice Dental Therapist
  • Grand Rapids, MN
  • NPI 1578117438
  NPD
• Andrew Stuart Kuehn, DDS

  • Dentist
  • Grand Rapids, MN
  • NPI 1063079242
  NPD (past)
• Mike N Miskovich, DDS

  • General Practice Dentistry
  • Grand Rapids, MN
  • NPI 1609941863
  NPD (past)

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642636800000",
    "number": "1396497434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1121 SE 4TH AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443956",
            "telephone_number": "218-326-3437",
            "fax_number": "218-327-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 SE 4TH AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557443956",
            "telephone_number": "218-326-3437",
            "fax_number": "218-327-1211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN DENTAL PARTNERS AND ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-20",
        "last_updated": "2022-01-20",
        "certification_date": "2022-01-20",
        "status": "A",
        "authorized_official_last_name": "MISKOVICH",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DENTIST/PARTNER",
        "authorized_official_telephone_number": "218-326-3437",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "274L7MI27SL",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "842936700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miskovich Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• North Homes, Inc. (saa)
• North Homes, Inc.
• North Homes, Inc. - Cadi-Waiver Services
• North Homes, Inc. - Chemical Dependency Program
• North Lakes Chiropractic
• Northern Orthotic and Prosthetic Center
• Northern Pines Orthopaedic Center, LLC
• Northern Pines Orthopaedic Clinic, P.a.
• Northland Counseling Center, Inc
• Northland Counseling Center, Inc.

• General Practice Dentistry in Grand Rapids, MN
• Providers in Grand Rapids, 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 Jan 20, 2022; 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.