Prairies Edge Dental LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PRAIRIES EDGE DENTAL LLC

Practice address

106 E Washington Ave
Fergus Falls, MN 56537-2853

Phone

(218) 739-2297

Fax

(218) 739-4142

NPI assigned

Apr 13, 2021

Last updated

Apr 13, 2021By 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

Rebekka Buchholz

Title

Office Manager

Phone

(218) 739-2297

Specialties & licenses 1

Addresses

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.

• Joseph David Greenagel, DDS

  • General Practice Dentistry
  • Fergus Falls, MN
  • NPI 1811041098
  NPD
• Eric J Strand, DDS

  • General Practice Dentistry
  • Fergus Falls, MN
  • NPI 1184066243
  NPD (past)

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

{
    "created_epoch": "1618272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1992385942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 E WASHINGTON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372853",
            "telephone_number": "218-739-2297",
            "fax_number": "218-739-4142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E WASHINGTON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372853",
            "telephone_number": "218-739-2297",
            "fax_number": "218-739-4142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIES EDGE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-13",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "BUCHHOLZ",
        "authorized_official_first_name": "REBEKKA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "218-739-2297"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Polejewski
• Marian Rae Porter, LPN
• William Calvin Porter, M.D.
• Amy Potts
• Amy Powers
• Lieah Rae Prechel, LPN
• Jessica E Price, PT
• Productive Alternatives Inc Professional Billing
• Productive Alternatives Inc.
• Productive Alternatives Volunteer Driver Program

• Dental Clinic/Center in Fergus Falls, MN
• Providers in Fergus Falls, 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 Apr 13, 2021; 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.