Organization Active NPI

Dr Krivarchka DDS

  • Dental Clinic/Center
  • Enderlin, ND
National Provider Identifier
1982015483
Registry record updated Jun 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DR KRIVARCHKA DDS
Practice address
213 4TH Ave
Enderlin, ND 58027-1306
Phone
(701) 437-2676
NPI assigned
May 19, 2014
Last updated
Jun 16, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2014

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

Authorized official

Name
Dr. Duane Krivarchka
Title
Dentist/Owner
Phone
(701) 437-2676

Specialties & licenses 1

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

Addresses

Primary practice location

213 4TH Ave
Enderlin, ND 58027-1306

Mailing address

213 4TH Ave
Enderlin, ND 58027-1306
Phone (701) 437-2676

Other identifiers 1

IdentifierTypeStateIssuer
40796MedicaidND

National Provider Directory

National Provider Directory

Locations

213 4th Ave
Enderlin, ND 58027
Phone (701) 437-2676

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402876800000",
    "number": "1982015483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 4TH AVE",
            "city": "ENDERLIN",
            "state": "ND",
            "postal_code": "580271306",
            "telephone_number": "701-437-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 4TH AVE",
            "city": "ENDERLIN",
            "state": "ND",
            "postal_code": "580271306",
            "telephone_number": "701-437-2676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR KRIVARCHKA DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-06-16",
        "status": "A",
        "authorized_official_last_name": "KRIVARCHKA",
        "authorized_official_first_name": "DUANE",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "701-437-2676",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "ND",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40796",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Enderlin, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; 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.