Glacier Dental Clinic

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

1843 Issued in MT

Legal business name

GLACIER DENTAL CLINIC

Practice address

140 S Central Ave
Cut Bank, MT 59427-3298

Phone

(406) 873-5222

NPI assigned

Jan 13, 2009

Last updated

Jan 13, 2009By the provider in NPPES

Organization subpart

Yes

Parent organization

GLACIER COMMUNITY HEALTH CENTER, INCAs reported in NPPES

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

Authorized official

Name

Sylvia Berkram

Title

Cfo

Phone

(406) 873-5670

Specialties & licenses 1

Addresses

Other identifiers 2

Tax ID family

Glacier Community Pharmacy3 organizations share this tax ID, including this one

Part of

Glacier Community Pharmacy

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Glacier Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Cut Bank, MT
  • NPI 1780764274
  NPD tax ID
• Glacier Community Pharmacy

  • Community/Retail Pharmacy
  • Cut Bank, MT
  • NPI 1962396903
  NPD tax ID

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AIAFAA

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.

• Carol Ann Milne, FNP

  • Nurse Practitioner
  • Havre, MT
  • NPI 1013922707
  NPD (past)

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231804800000",
    "number": "1497992424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 E MAIN ST",
            "city": "CUT BANK",
            "state": "MT",
            "postal_code": "594273015",
            "telephone_number": "406-873-5670",
            "fax_number": "406-873-2256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S CENTRAL AVE",
            "city": "CUT BANK",
            "state": "MT",
            "postal_code": "594273298",
            "telephone_number": "406-873-5222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER DENTAL CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GLACIER COMMUNITY HEALTH CENTER, INC",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-01-13",
        "status": "A",
        "authorized_official_last_name": "BERKRAM",
        "authorized_official_first_name": "SYLVIA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "406-873-5670"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MT",
            "license": "1843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "000084542",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "730418",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hoang Girgen, PHARMD
• Glacier Care Center, Inc. (Glacier Care Center)
• Glacier Community Health Center Inc
• Glacier Community Pharmacy
• Glacier County Health Department
• Glacier Nursing and Rehab Center, LLC
• Glacier Pharmacy LLC
• Virginia Gosney, LAC
• Mark Ernest Haemig, DDS
• Athena Jane Ocampo Halol, MD

• Dental Clinic/Center in Cut Bank, MT
• Providers in Cut Bank, MT by specialty
• Dental Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.