Missouri River Dental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2214 Issued in ND

Legal business name

MISSOURI RIVER DENTAL, PC

Practice address

1401 Skyline Blvd
Suite 210
Bismarck, ND 58503-1299

Phone

(701) 751-7177

Fax

(701) 751-7178

NPI assigned

May 30, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Timothy Alworth Anderson, D.D.S

Title

President

Phone

(612) 619-0917

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Bethany Schuetzle, D.D.S

  • Dentist
  • Bismarck, ND
  • NPI 1093156093
  NPD (past)

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

{
    "created_epoch": "1401408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401408000000",
    "number": "1992117501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 SKYLINE BLVD",
            "address_2": "SUITE 210",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031299",
            "telephone_number": "701-751-7177",
            "fax_number": "701-751-7178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 SKYLINE BLVD",
            "address_2": "SUITE 210",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031299",
            "telephone_number": "701-751-7177",
            "fax_number": "701-751-7178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOURI RIVER DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-30",
        "last_updated": "2014-05-30",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "ALWORTH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-619-0917",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "ND",
            "license": "2214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Av Mirzai, MD
• Calsey Mischel, M.D.
• Kelsey Mischel, DPT
• Amy Mischke
• Missouri Basin Anesthesia, PLLC
• Missouri River Health
• Missouri Slope at Home, LLC
• Missouri Slope Lutheran Care Center, Inc. (Missouri Slope)
• Missouri Slope Lutheran Care Center, Inc.
• Jared Mitchell, PEER SUPPORT

• General Practice Dentistry in Bismarck, ND
• Providers in Bismarck, ND by specialty
• General Practice Dentistry in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.