DENTAL ASSOCIATES-ESKO INCORPORATED P C
Complete NPI Record 1013081736
Dentist - General Practice in Esko, MN

NPI Status: Active since November 17, 2006

Contact Information

4 HIGHWAY 61
ESKO, MN
ZIP 55733
Phone: (218) 879-8355
Fax: (218) 879-8352

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Complete NPI Dataset

The following table represents the complete dataset for NPI number 1013081736. The table includes a list of all field names, values and definitions of the full NPI record. This dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1013081736The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code2Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EINUNAVAILThe Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
Provider Organization Name Legal Business NameDENTAL ASSOCIATES-ESKO INCORPORATED P CThe name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address4 W HIGHWAY 61The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Second Line Business Mailing AddressPO BOX 394The second line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider second line location address’’.
Provider Business Mailing Address City NameESKOThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameMNThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code557339701The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number2188798355The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number2188798352The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address4 HIGHWAY 61The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameESKOThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMNThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code557330394The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number2188798355The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2188798352The fax number associated with the location address of the provider being identified.
Provider Enumeration Date11/17/2006The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date5/27/2021The date that a record was last updated or changed.
Authorized Official Last NameSHARMAThe last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameROOPALIThe first name of the authorized official.
Authorized Official Title or PositionOWNERThe title or position of the authorized official.
Authorized Official Telephone Number2188798355The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 11223G0001XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1Y
Other Provider Identifier 1777522900Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 105Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1MN
Is Organization SubpartN
Authorized Official Name Prefix TextDR.
Authorized Official Name Suffix TextIX
Authorized Official Credential TextD.D.S
Healthcare Provider Taxonomy Group 1193400000X SINGLE SPECIALTY GROUP
NPI Certification Date5/27/2021