Patrick Gary Becicka, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D10974 Issued in MN

Practice address

5047 Jason Ave NE
Albertville, MN 55301-9688

Phone

(763) 497-8165

Fax

(763) 497-8162

NPI assigned

Dec 6, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Albertville Family Dental

  • Dental Clinic/Center
  • Albertville, MN
  • NPI 1033726161
  NPD Authorized official
• Minnesota Dental Professionals, P.C.

  dba Albertville Family Dental

  • General Practice Dentistry
  • Albertville, MN
  • NPI 1144064700
  NPD (past)

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952469280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5047 JASON AVE NE",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553019688",
            "telephone_number": "763-497-8165",
            "fax_number": "763-497-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5047 JASON AVE NE",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "553019688",
            "telephone_number": "763-497-8165",
            "fax_number": "763-497-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECICKA",
        "first_name": "PATRICK",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Askegaard, DDS
• Associated Dental (Assure Dental)
• Nora Baebenroth
• Zabracca Baldwin, IBCLC
• Kelsey Beaumaster
• Ashley Berning, RN
• Katherine Berthiaume
• Bailey Bladholm
• Brightstar Behavioral Health Services LLC
• Courtney A. Buley

• General Practice Dentistry in Albertville, MN
• Providers in Albertville, 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 Jul 8, 2007; 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.