Grand Marais Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11942 Issued in MN

Legal business name

GRAND MARAIS FAMILY DENTISTRY

Practice address

303 E 3Rd St
Grand Marais, MN 55604

Phone

(218) 387-2774

Fax

(218) 387-1393

NPI assigned

Sep 3, 2013

Organization subpart

No

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

Authorized official

Name

Alyssa HedstromNPI 1487879243

Title

President

Phone

(218) 387-2774

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Alyssa Anne Hedstrom, D.D.S.

  • General Practice Dentistry
  • Grand Marais, MN
  • NPI 1487879243
  NPD (past) Authorized official
• Rolf E Lindquist, DDS

  • General Practice Dentistry
  • Grand Marais, MN
  • NPI 1326191917
  NPD (past)
• Reilly Ardath Wahlers, DH

  • Dental Hygienist
  • Grand Marais, MN
  • NPI 1689531980

  Single Specialty

  NPD (past)
• Brooklynn Kaye Johnke, DT,RDH

  • Dental Therapist
  • Oakland, ME
  • NPI 1215604988
  NPD (past)

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

{
    "created_epoch": "1378166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1378166400000",
    "number": "1518391010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 670",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "556040670",
            "telephone_number": "218-387-2774",
            "fax_number": "218-387-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 E 3RD ST",
            "city": "GRAND MARAIS",
            "state": "MN",
            "postal_code": "55604",
            "telephone_number": "218-387-2774",
            "fax_number": "218-387-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND MARAIS FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-03",
        "last_updated": "2013-09-03",
        "status": "A",
        "authorized_official_last_name": "HEDSTROM",
        "authorized_official_first_name": "ALYSSA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-387-2774"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer L Delfs, M.D.
• Margarette Farchmin
• Erika Figueria-Basheer, LCSW
• Lindsey Gau, MFT
• Thomas Arnold Gaylord, R.PH.
• Great Expectations School
• Gunflint Trail Volunteer Fire Department
• Amanda County Hand
• Catherine Marie Hansen, M.D.
• Kelly Jo Hawsen, MA, LPC

• General Practice Dentistry in Grand Marais, MN
• Providers in Grand Marais, 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 Sep 3, 2013; 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.