Black Bear Family Dental PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLACK BEAR FAMILY DENTAL PC

Practice address

1628 30TH St NW
Bemidji, MN 56601-4690

Phone

(218) 444-2004

NPI assigned

Nov 6, 2018

Last updated

Nov 6, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Veronica Cooper, DDSNPI 1194944876

Title

President

Phone

(218) 444-2004

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Veronica Lin Cooper, DDS

  • Dentist
  • Bemidji, MN
  • NPI 1194944876
  NPD (past) Authorized official
• Alison Lynn Sauer, DDS

  • Dentist
  • Bemidji, MN
  • NPI 1255910121
  NPD (past)

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

{
    "created_epoch": "1541462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541462400000",
    "number": "1609344894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014690",
            "telephone_number": "218-444-2004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 30TH ST NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566014690",
            "telephone_number": "218-444-2004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK BEAR FAMILY DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-06",
        "last_updated": "2018-11-06",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-444-2004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Birch
• Jan Birch, MSW, LICSW
• Heather Bird, CHW
• Mindie Bird, LADC
• Sarah Bjornson, MA, LPCC
• Megan June Blaschko
• Tracy C Blichfeldt, MD
• Susan Kay Bloomquist
• William L Bock, MD
• Charlotte Anne Bogotty

• Dental Clinic/Center in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2018; 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.