Riverside Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

2037 Issued in ND

Legal business name

RIVERSIDE DENTAL PLLC

Practice address

1165 S Columbia Rd
Ste. B
Grand Forks, ND 58201-4007

Phone

(701) 772-3544

Fax

(701) 772-3411

NPI assigned

May 2, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Amanda Vesterso, DDS

Title

Owner

Phone

(701) 772-3544

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Sarah Elizabeth Rehovsky, DDS

  • General Practice Dentistry
  • Grand Forks, ND
  • NPI 1952970733
  NPD (past)

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

{
    "created_epoch": "1493683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1609302231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1165 S COLUMBIA RD",
            "address_2": "STE. B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014007",
            "telephone_number": "701-772-3544",
            "fax_number": "701-772-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 S COLUMBIA RD",
            "address_2": "STE. B",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014007",
            "telephone_number": "701-772-3544",
            "fax_number": "701-772-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-02",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "VESTERSO",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-772-3544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "ND",
            "license": "2037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Louise Riske, RN, CNS
• Sandra Ristau
• Blake Ristvedt, D.D.S.
• Rachel Rivera
• Riverbend Psychiatry, PLLC
• Allison Carmella Robberstad, LAC
• Kyle Robbins, ATC
• Melissa Margaret Robbins, LRD
• Robert M Simons LTD
• Amy Marie Roberts

• Dentist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Dentist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.