Ideal Image Dentistry & Spa

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1593 Issued in ND

Legal business name

IDEAL IMAGE DENTISTRY & SPA

Practice address

1008 E Main St
Mandan, ND 58554-3762

Phone

(701) 667-1933

NPI assigned

Jan 25, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Fredrick A Landgrebe, DDS

Title

Owner/Dentist

Phone

(701) 667-1933

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Frederick Arnold Landgrebe

  • General Practice Dentistry
  • Mandan, ND
  • NPI 1568517779
  NPD (past)

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

{
    "created_epoch": "1295913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1891090668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 E MAIN ST",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543762",
            "telephone_number": "701-667-1933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 E MAIN ST",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "585543762",
            "telephone_number": "701-667-1933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL IMAGE DENTISTRY & SPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-25",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "LANDGREBE",
        "authorized_official_first_name": "FREDRICK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "701-667-1933",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "1593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41545",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Danielle Howard, LPN
• Morgan Howard
• Crystal L Huber, PT
• Nancy Hunskor
• Ndaiziweyi Hybsha
• Impact Therapy, PLLC
• Innovative Therapy Solutions & Consulting LLC
• Whitney Marie Irmen, LSW
• Erik Isaacson, DC
• Erin Mercedes Isaacson, OTR/L

• General Practice Dentistry in Mandan, ND
• Providers in Mandan, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2011; 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.