Lifetime Dental Partners, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

1904 Issued in ND

Legal business name

LIFETIME DENTAL PARTNERS, PLLC

Practice address

321 Briggs Ave S
Suite 3
Park River, ND 58270

Phone

(701) 284-7777

Fax

(701) 284-6776

NPI assigned

Jul 31, 2014

Organization subpart

No

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

Authorized official

Name

Roberta Lea Ekman, DDSNPI 1033137070

Title

Owner

Phone

(701) 352-2450

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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

• Roberta L Ekman, DENTIST

  • General Practice Dentistry
  • Park River, ND
  • NPI 1033137070
  NPD (past) Authorized official
• Paul Benedict Dusek, DDS

  • Dentist
  • Park River, ND
  • NPI 1104317189
  NPD (past)

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

{
    "created_epoch": "1406764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1669880845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "927 W 12TH ST",
            "city": "GRAFTON",
            "state": "ND",
            "postal_code": "582372121",
            "telephone_number": "701-352-2450",
            "fax_number": "701-352-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 BRIGGS AVE S",
            "address_2": "SUITE 3",
            "city": "PARK RIVER",
            "state": "ND",
            "postal_code": "58270",
            "telephone_number": "701-284-7777",
            "fax_number": "701-284-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFETIME DENTAL PARTNERS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-31",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "EKMAN",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "LEA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-352-2450",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ND",
            "license": "1904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1458306",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Corissa Rae Kruse
• Pam Landsem
• Brian James Larson, DDS
• Gerald Duane Larson, DDS
• Laurelyn Joann Larson
• Crystal A Lundmark
• Piper Luoto, PHARMD, RPH
• Midgarden Family Clinic PC
• Kristi J Midgarden, M.D.
• P R Health Corporation

• All providers in Park River, ND
• Dental Clinic/Center in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; 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.