Daniel L. Mengedoth, DDS LTD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11185 Issued in MN

Legal business name

DANIEL L. MENGEDOTH, DDS LTD

Practice address

2121 Highway 10 E
Moorhead, MN 56560-2559

Phone

(218) 236-7076

Fax

(218) 236-4999

NPI assigned

Aug 7, 2006

Last updated

Dec 3, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel L Mengedoth, D.D.S.

Title

Ceo

Phone

(218) 236-7076

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1942219852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 HIGHWAY 10 E",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602559",
            "telephone_number": "218-236-7076",
            "fax_number": "218-236-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 HIGHWAY 10 E",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565602559",
            "telephone_number": "218-236-7076",
            "fax_number": "218-236-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL L. MENGEDOTH, DDS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "MENGEDOTH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-236-7076",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Moorhead, MN
• Providers in Moorhead, 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 Dec 3, 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.