DEER RIVER DENTAL CLINIC
NPI 1417464157
Dentist - Endodontics in Deer River, MN
NPI Status: Active since January 03, 2018
Contact Information
111 MAIN STREET E
DEER RIVER, MN
ZIP 56636
Phone: (218) 246-8200
- Organization
- Dentist
- Endodontics
- CLIA Number: 24D0406583
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 04-16-2027
About DEER RIVER DENTAL CLINIC
This page provides the complete NPI Profile along with additional information for Deer River Dental Clinic, a provider established in Deer River, Minnesota operating as a Dentist, focusing in endodontics . The healthcare provider is registered in the NPI registry with number 1417464157 assigned on January 2018. The practitioner's primary taxonomy code is 1223E0200X with license number D9499 (MN). The provider is registered as an organization and their NPI record was last updated 8 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Jeffrey Lee Ccarter Dds (Dentist/owner)
- NPI
- 1417464157
- Provider Name
- DEER RIVER DENTAL CLINIC
- Entity Type
- Organization
- Location Address
- 111 MAIN STREET E DEER RIVER, MN 56636
- Location Phone
- (218) 246-8200
- Mailing Address
- PO BOX 40 DEER RIVER, MN 56636
- Mailing Phone
- (218) 246-8200
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-03-2018
- Last Update Date
- 01-03-2018
- Code Navigator
A dentist like Deer River Dental Clinic is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Dentist Endodontics
- Taxonomy Code
- 1223E0200X
- Type
- Dental Providers
- License No.
- D9499
- License State
- MN
- Taxonomy Description
- The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 24D0406583
- Facility Type
- Hospital
- Certificate Effective Date
- April 17, 2025
- Certificate Expiration Date
- April 16, 2027
- Laboratory Director
- BENJAMIN KOCH
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Deer River Dental Clinic on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1417464157, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1417464157, enumerated as an "organization" on January 03, 2018.
The provider is located at 111 MAIN STREET E DEER RIVER, MN 56636 and the phone number is (218) 246-8200.
Dentist with taxonomy code 1223E0200X and a focus in Endodontics.
