NPIMap

Organization Active NPI

North Shore Family Dental

  • Dentist
  • Duluth, MN
National Provider Identifier
1508074485
Registry record updated Jan 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D9070 Issued in MN
Legal business name
NORTH SHORE FAMILY DENTAL
Practice address
1932 London Rd
Duluth, MN 55812-2038
Phone
(218) 728-2144
Fax
(218) 529-1623
NPI assigned
May 21, 2007
Last updated
Jan 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2008

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

Authorized official

Name
Dr. Calvin Brent Haworth, D.D.S.NPI 1013138205
Title
Dentist
Phone
(218) 728-2144

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D9070 MN Primary

Addresses

Primary practice location

1932 London Rd
Duluth, MN 55812-2038

Mailing address

1932 London Rd
Duluth, MN 55812-2038
Phone (218) 728-2144

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199404800000",
    "number": "1508074485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1932 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122038",
            "telephone_number": "218-728-2144",
            "fax_number": "218-529-1623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1932 LONDON RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558122038",
            "telephone_number": "218-728-2144",
            "fax_number": "218-529-1623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-01-04",
        "status": "A",
        "authorized_official_last_name": "HAWORTH",
        "authorized_official_first_name": "CALVIN",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "218-728-2144",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D9070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.