NPIMap

Organization Active NPI

Pelican Dental

  • Dental Clinic/Center
  • Pelican Rapids, MN
National Provider Identifier
1831689884
Registry record updated May 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D10376 Issued in MN
Legal business name
PELICAN DENTAL
Practice address
28 E Mill Ave Ste 1
Pelican Rapids, MN 56572-4229
Phone
(218) 863-5858
Fax
(218) 863-1143
NPI assigned
May 15, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2018

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

Authorized official

Name
Dr. David Michael Ditch, DDSNPI 1417062969
Title
Owner/Dentist
Phone
(218) 863-5858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D10376 MN Primary

Addresses

Primary practice location

28 E Mill Ave Ste 1
Pelican Rapids, MN 56572-4229

Mailing address

PO Box 342
Pelican Rapids, MN 56572-0342
Phone (218) 863-5858

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1526342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526342400000",
    "number": "1831689884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 342",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565720342",
            "telephone_number": "218-863-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 E MILL AVE STE 1",
            "city": "PELICAN RAPIDS",
            "state": "MN",
            "postal_code": "565724229",
            "telephone_number": "218-863-5858",
            "fax_number": "218-863-1143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-05-15",
        "status": "A",
        "authorized_official_last_name": "DITCH",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "218-863-5858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D10376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelican Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2018; 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.