Great River Dentistry of Bemidji, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GREAT RIVER DENTISTRY OF BEMIDJI, PLLC

Practice address

3622 Moberg Dr NW
Bemidji, MN 56601-5644

Phone

(218) 751-4216

Fax

(218) 444-6057

NPI assigned

Nov 3, 2016

Organization subpart

No

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

Authorized official

Name

Baret Williams-FurfaroNPI 1093094039

Title

Owner DDS

Phone

(218) 751-4216

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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

• Baret Williams-Furfaro

  • Dentist
  • Bemidji, MN
  • NPI 1093094039
  NPD (past) Authorized official
• Bailee Jo Hedberg, MDT, RDH

  • Dental Therapist
  • Bemidji, MN
  • NPI 1619441219
  NPD (past)
• Jack Richard Sauer

  • Dentist
  • Bemidji, MN
  • NPI 1447839311
  NPD (past)
• Laura Ann Schwindt, DDS

  • Dentist
  • Bemidji, MN
  • NPI 1477751816
  NPD (past)

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

{
    "created_epoch": "1478131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478131200000",
    "number": "1982156147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1005",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566191005",
            "telephone_number": "218-751-4216",
            "fax_number": "218-444-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 MOBERG DR NW",
            "city": "BEMIDJI",
            "state": "MN",
            "postal_code": "566015644",
            "telephone_number": "218-751-4216",
            "fax_number": "218-444-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER DENTISTRY OF BEMIDJI, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-03",
        "last_updated": "2016-11-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS-FURFARO",
        "authorized_official_first_name": "BARET",
        "authorized_official_title_or_position": "OWNER DDS",
        "authorized_official_telephone_number": "218-751-4216"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Alexander Eric Graham, PSYCHOLOGIST
• Grand St Paul CVS LLC
• Grand St. Paul CVS LLC
• Joshua Herold Vernon Granly, REGISTERED NURSE
• Great River Dentistry of Bemidji, P.a.
• Great River Psychological Services, P.a.
• Great Western Medical Group PLLC
• Margaret Grob, PT
• John Grygelko, PHARMD
• Sondra L. Gudmundson, R.D.

• Dental Clinic/Center in Bemidji, MN
• Providers in Bemidji, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2016; 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.