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FOND DU LAC HUMAN SERVICES DIVISION DENTAL CLINIC
NPI 1063723138
Clinic/Center - Dental in Cloquet, MN

Active since June 23, 2010CLIA 24D2151041 · Waiver
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION DENTAL CLINIC, CLOQUET, MN 55720(218) 879-1227(218) 878-3755 Get Directions Write a Review

NPPES record last updated: June 23, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Fond Du Lac Human Services Division Dental Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOND DU LAC HUMAN SERVICES DIVISION DENTAL CLINIC (NPI 1063723138) is a healthcare organization registered as a dental in Cloquet, Minnesota and active in the NPI registry since June 2010. The organization holds a CLIA Waiver certificate valid through July 9, 2028 and lists Karen R Diver, Chairwoman, as its authorized official.

NPPES Registry Identity

NPI1063723138
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameFOND DU LAC RESERVATION BUSINESS COMMITTE
Location Address927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION DENTAL CLINICCloquet, MN 55720
Mailing Address927 Trettel Lane, Fond Du Lac Human Services Division Dental ClinicCloquet, MN 55720 · (218) 879-1227 · Fax (218) 878-3755
Phone(218) 879-1227
Fax(218) 878-3755
Organization SubpartYesParent: Fond Du Lac Reservation Business Committee
Authorized OfficialKaren R DiverChairwoman · (218) 879-4593
Enumeration DateJune 23, 2010
✔ NPI 1063723138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
927 TRETTEL LANE, Cloquet, MN 55720
Open in Google Maps ↗

Other Names 1

Doing Business AsFond Du Lac Human Services Division Dental Clinic

Other Identifiers 2

Medicare UPINC06351MN
Medicaid666815100MN

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 24D2151041

Fond Du Lac Human Services Division - Community Screening · Cloquet, MN
Active · expires Jul 9, 2028
CLIA Number24D2151041
Laboratory TypeHealth Fair
Certificate Effective DateJuly 10, 2026
Certificate Expiration DateJuly 9, 2028
Laboratory DirectorLisa M. Hollinday
Laboratory Phone(218) 879-1227
Laboratory LocationFond Du Lac Human Services Division - Community Screening927 Trettel Lane, Cloquet, MN 55720
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEANNE RICE O.D.
Optometrist
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION
CLOQUET, MN 55720
Carlton County (218) 879-1227
JESSICA ANNE LINDE PHARMD
Pharmacist
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION
CLOQUET, MN 55720
Carlton County (218) 878-2185
FOND DU LAC RESERVATION BUSINESS COMMITTEE
Clinic/Center (Rehabilitation, Substance Use Disorder)
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION
CLOQUET, MN 55720
Carlton County (218) 879-1227
ELENORE C SCHOENFELD LICSW
Social Worker (Clinical)
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION
CLOQUET, MN 55720
Carlton County (218) 878-2185
JAMIE JOHANNA KRAUS PHARMD
Pharmacist
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION
CLOQUET, MN 55720
Carlton County (218) 878-2185
TAWNY LEE SMITH-SAVAGE LCSW LADC
Counselor (Addiction (Substance Use Disorder))
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION
CLOQUET, MN 55720
Carlton County (218) 878-2185
BEN EARL ANDERSON PHARMD
Pharmacist
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION
CLOQUET, MN 55720
Carlton County (218) 878-2185
JAMIE WADE DDS
Dentist (General Practice)
927 TRETTEL LANE, FOND DU LAC HUMAN SERVICES DIVISION927 TRETTEL LANE
CLOQUET, MN 55720
Carlton County (218) 879-1227

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Fond Du Lac Reservation Business Committe's NPI number?

The NPI number for Fond Du Lac Reservation Business Committe is 1063723138. It was assigned to this organization in the NPPES registry on June 23, 2010. The provider is doing business as Fond Du Lac Human Services Division Dental Clinic.

Where is Fond Du Lac Reservation Business Committe located?

Fond Du Lac Reservation Business Committe is located at 927 Trettel Lane Fond Du Lac Human Services Division Dental Clinic, Cloquet, MN 55720. The listed phone number is (218) 879-1227.

What is Fond Du Lac Reservation Business Committe's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

Does Fond Du Lac Reservation Business Committe hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 24D2151041) is associated with this NPI, valid through July 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Fond Du Lac Reservation Business Committe was last updated on June 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.