Bethany L. Baillargeon Marx, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13461 Issued in MN

Practice address

22 5TH Ave NE
Pelican Rapids, MN 56572-4126

Phone

(218) 863-7511

NPI assigned

Jun 29, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeland Smiles, PLLC

  • Dental Clinic/Center
  • Pelican Rapids, MN
  • NPI 1467807412
  NPD
• Dakota Smiles, PLLC

  • General Practice Dentistry
  • Fargo, ND
  • NPI 1740430198
  NPD (past)

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

{
    "created_epoch": "1277769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641513600000",
    "number": "1598076119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 44TH STREET SOUTH",
            "address_2": "SUITE 100",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-235-2860",
            "fax_number": "701-235-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 5TH AVE NE",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565724126",
            "telephone_number": "218-863-7511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAILLARGEON MARX",
        "first_name": "BETHANY",
        "middle_name": "L.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-29",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ND",
            "license": "2232",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2011039028",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "6507",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Affield, PA-C
• Alexa Briard, BAN, RN, PHN, IBCLC
• Community & Life Services
• Robert L Dahl, OTR/L
• Daniel Ditch, DDS
• David Michael Ditch, DDS

• Dentist in Pelican Rapids, MN
• Providers in Pelican Rapids, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.