Active NPI
Clarissa Mary Sparkman, D.M.D
- Dentist
- Hibbing, MN
National Provider Identifier
1689937526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D13098
- Practice address
- 802 W 42ND St
Hibbing, MN 55746-3222 - Phone
- (218) 263-8381
- Fax
- (218) 263-8383
- NPI assigned
- Jun 15, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D13098 | MN | Primary |
Addresses
Primary practice location
802 W 42ND St
Hibbing, MN 55746-3222
Mailing address
802 W 42ND St
Hibbing, MN 55746-3222
Phone (218) 263-8381
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518086750 | Medicaid | MN | |
| 40058 | Medicaid | ND |
Other names 1
- Miss Clarissa Mary Sliwoski
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D13098 | MN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Plum Tree Dental | Current | Accepting new patients | |
| Dental Health Service of Northern Minnesota PA | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Virginia, MN
- NPI 1093607764
-
- General Practice Dentistry
- Hibbing, MN
- NPI 1518086750
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1689937526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 W 42ND ST",
"city": "HIBBING",
"state": "MN",
"postal_code": "557463222",
"telephone_number": "218-263-8381",
"fax_number": "218-263-8383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 W 42ND ST",
"city": "HIBBING",
"state": "MN",
"postal_code": "557463222",
"telephone_number": "218-263-8381",
"fax_number": "218-263-8383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPARKMAN",
"first_name": "CLARISSA",
"middle_name": "MARY",
"name_prefix": "Mrs.",
"credential": "D.M.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-15",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MN",
"license": "D13098",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1518086750",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40058",
"state": "ND"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CLARISSA",
"last_name": "SLIWOSKI",
"middle_name": "MARY",
"prefix": "MISS",
"credential": "D.M.D",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hibbing, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.