Elbow Lake Dentistry, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ELBOW LAKE DENTISTRY, PLLC

Practice address

18 W Division St
Elbow Lake, MN 56531-4136

Phone

(218) 685-4710

NPI assigned

Sep 29, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Brady Elmer Weispfennig, DDS

Title

Sole Member

Phone

(320) 491-0300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1601337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601337600000",
    "number": "1740897156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "565310026",
            "telephone_number": "218-685-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 W DIVISION ST",
            "city": "ELBOW LAKE",
            "state": "MN",
            "postal_code": "565314136",
            "telephone_number": "218-685-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELBOW LAKE DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-29",
        "last_updated": "2020-09-29",
        "certification_date": "2020-09-29",
        "status": "A",
        "authorized_official_last_name": "WEISPFENNIG",
        "authorized_official_first_name": "BRADY",
        "authorized_official_middle_name": "ELMER",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "320-491-0300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Walter Anderson, EDD, LMHC, LPCC, LAD
• Susan Marie Berg, PA-C
• Elbow Lake Dental Center, Inc.
• Eleah Medical Center
• Grant County Social Services
• Grant County Transportation
• Pamla Sandra Greiner, RN, CNP
• Phillip Walter Holmes, M.D.

• General Practice Dentistry in Elbow Lake, MN
• Providers in Elbow Lake, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2020; 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.