Dermatology Associates, P.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY ASSOCIATES, P.C.

Doing business as

Dermatology Associates

Practice address

4133 30TH Ave S Ste 101
Fargo, ND 58104

Phone

(701) 478-7747

Fax

(701) 478-7748

NPI assigned

Dec 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Beth A Honl

Title

Physician

Phone

(701) 478-7747

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Dermatology Associates Doing business as

Locations

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

{
    "created_epoch": "1198886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548201600000",
    "number": "1821273681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4133 30TH AVE S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-478-7747",
            "fax_number": "701-478-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4133 30TH AVE S STE 101",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58104",
            "telephone_number": "701-478-7747",
            "fax_number": "701-478-7748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-29",
        "last_updated": "2019-01-23",
        "status": "A",
        "authorized_official_last_name": "HONL",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "701-478-7747",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026092400",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12984",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MN",
            "identifier": "246K7DE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ND",
            "identifier": "06218001",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dermatology Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Dermatology Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dermatology Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Dermatology Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; 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.