Andrew Steven Atchison – General Practice Dentistry

Key facts

NPI: 1992908255
Entity type: Individual (NPI type 1)
Primary specialty: General Practice Dentistry 1223G0001X
License: D12404 (MN)
Practice address: 2121 Highway 10 E
Moorhead, MN 56560-2559
Phone: (218) 236-7076
Fax: (218) 236-4999
NPI assigned: Jun 6, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Northland Dental Partners, PLLC General Practice Dentistry · Osseo, MN · NPI 1952051682

NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
D12404	MN	MD	General Practice Dentistry

Practice roles

Organization	Specialty	Status	New patients
Northland Dental Partners, PLLC	General Practice	Past since Mar 27, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
General Practice Dentistry	1223G0001X	D12404	MN	Yes

Addresses

Primary practice location

2121 Highway 10 E
Moorhead, MN 56560-2559

Mailing address

2121 Highway 10 E
Moorhead, MN 56560-2559
Phone (218) 236-7076

Other practice location 1

40 Central Ave
Osseo, MN 55369-1241
Phone (763) 425-3023

Other providers in Moorhead, MN

All providers in Moorhead, MN · General Practice Dentistry in Minnesota

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.