NPIMap

Organization Active NPI

Dreamhaven Dental Sleep Medicine

  • Dental Clinic/Center
  • Baxter, MN
National Provider Identifier
1811327190
Registry record updated Nov 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D10518 Issued in MN
Legal business name
DREAMHAVEN DENTAL SLEEP MEDICINE
Practice address
13495 Elder Dr
Suite 100
Baxter, MN 56425-8763
Phone
(218) 454-0523
NPI assigned
Nov 22, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2013

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

Authorized official

Name
Dr. Clinton Lawrence Roberts, DDS
Title
Owner Dentist
Phone
(218) 454-0523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D10518 MN Primary

Addresses

Primary practice location

13495 Elder Dr
Suite 100
Baxter, MN 56425-8763

Mailing address

13495 Elder Drive
Suite 100
Baxter, MN 56425
Phone (218) 454-0523

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385078400000",
    "number": "1811327190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13495 ELDER DRIVE",
            "address_2": "SUITE 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "56425",
            "telephone_number": "218-454-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13495 ELDER DR",
            "address_2": "SUITE 100",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564258763",
            "telephone_number": "218-454-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DREAMHAVEN DENTAL SLEEP MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-22",
        "last_updated": "2013-11-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "218-454-0523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D10518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.