Professional Optical

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

PROFESSIONAL OPTICAL

Practice address

4344 20TH Ave SW
Fargo, ND 58103-7436

Phone

(701) 298-0643

Fax

(701) 293-0909

NPI assigned

Sep 10, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Daniel J Levin, OD

Title

Doctor/Owner

Phone

(701) 298-0643

Specialties & licenses 1

Addresses

Tax ID family

Professional Optical2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Professional Optical

  • Eyewear Supplier
  • Fargo, ND
  • NPI 1366636599
  NPD tax ID

Locations

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1710210646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4344 20TH AVE SW",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037436",
            "telephone_number": "701-298-0643",
            "fax_number": "701-293-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4344 20TH AVE SW",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581037436",
            "telephone_number": "701-298-0643",
            "fax_number": "701-293-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-10",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LEVIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "701-298-0643",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie Prochniak
• Lindsay J Prochnow, RPHTECH, CHW
• Savannah Leigh Prodzinski, PA-C
• Professional Association of Treatment Homes
• Professional Optical
• Professional Rehabilitation Center
• Professional Rehabilitation Center
• Professional Rehabilitation Center Inc
• Professional Rehabilitation Center Inc
• Professional Rehabilitation Center Inc

• Eyewear Supplier in Fargo, ND
• Providers in Fargo, ND by specialty
• Eyewear Supplier in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.