Balaton Dental Clinic,Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10227 Issued in MN

Legal business name

BALATON DENTAL CLINIC,INC

Practice address

123 3Rd St
Balaton, MN 56115-9451

Phone

(507) 734-2251

Fax

(507) 734-2077

NPI assigned

Oct 9, 2013

Last updated

Oct 9, 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. Richard Wallace Brown, DDSNPI 1750457396

Title

Owner/Dentist

Phone

(507) 734-2251

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard Wallace Brown, DDS

  • Dentist
  • Balaton, MN
  • NPI 1750457396
  NPD (past) Authorized official
• Kathryn Determan, DDS

  • General Practice Dentistry
  • Balaton, MN
  • NPI 1104348697
  NPD (past)

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1381276800000",
    "number": "1982031878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 3RD ST",
            "address_2": "P.O.BOX 186",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "561159451",
            "telephone_number": "507-734-2251",
            "fax_number": "507-734-2077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 3RD ST",
            "city": "BALATON",
            "state": "MN",
            "postal_code": "561159451",
            "telephone_number": "507-734-2251",
            "fax_number": "507-734-2077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALATON DENTAL CLINIC,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-09",
        "last_updated": "2013-10-09",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "WALLACE",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "507-734-2251",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE",
            "identifier": "996822900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Balaton Public School
• Richard Wallace Brown, DDS
• City of Balaton (Balaton Ambulance)
• Kathryn Determan, DDS
• Jenna Elizabeth Erickson, CNM. IBCLC

• General Practice Dentistry in Balaton, MN
• Providers in Balaton, 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 Oct 9, 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.