Chisholm Dental Service PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3613539 Issued in MN

Legal business name

CHISHOLM DENTAL SERVICE PA

Practice address

217 1St St NW
Chisholm, MN 55719-1701

Phone

(218) 254-3311

Fax

(218) 254-4531

NPI assigned

Dec 16, 2006

Last updated

Aug 22, 2020By 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

Dr. Harold Goodman Swennes III, DDSNPI 1528049624

Title

Dentist

Phone

(218) 254-3311

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Harold Goodman Swennes III, DDS

  • Dentist
  • Chisolm, MN
  • NPI 1528049624
  NPD (past) Authorized official
• Steve G Enich, D.D.S

  • General Practice Dentistry
  • Chisholm, MN
  • NPI 1518020809
  NPD (past)
• Jennifer Kaczor, DDS

  • General Practice Dentistry
  • Chisholm, MN
  • NPI 1902423452
  NPD (past)

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396807012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632",
            "city": "CHISHOLM",
            "state": "MN",
            "postal_code": "557190632",
            "telephone_number": "218-254-3311",
            "fax_number": "218-254-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 1ST ST NW",
            "city": "CHISHOLM",
            "state": "MN",
            "postal_code": "557191701",
            "telephone_number": "218-254-3311",
            "fax_number": "218-254-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHISHOLM DENTAL SERVICE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWENNES",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_middle_name": "GOODMAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "218-254-3311",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "3613539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Drug-a Inc
• Casey Drug-a Inc (Casey Drug)
• Aden Casey, PHARMD
• Alida Erin Casey, PHARM D
• Children's Dental Services
• Chisholm Health Center (Heritage Manor)
• Chisholm Medical Clinic
• City of Chisholm
• E.H. Lawrence Co., Inc.
• Timothy William Ellison

• Dental Clinic/Center in Chisholm, MN
• Providers in Chisholm, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.