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GREAT RIVER DENTISTRY OF BEMIDJI, P.A.
NPI 1821260654
Dentist - General Practice in Bemidji, MN

Active since April 01, 2008
3622 MOBERG DR NW, BEMIDJI, MN 56601(218) 751-4216(218) 444-6057 Get Directions Write a Review

NPPES record last updated: June 11, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Great River Dentistry Of Bemidji, P.a. NPPES

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

GREAT RIVER DENTISTRY OF BEMIDJI, P.A. (NPI 1821260654) is a healthcare organization registered as a general practice in Bemidji, Minnesota and active in the NPI registry since April 2008. The organization lists Douglas R Williams, Owner, as its authorized official.

NPPES Registry Identity

NPI1821260654
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameGREAT RIVER DENTISTRY OF BEMIDJI, P.A.
Location Address3622 MOBERG DR NWBemidji, MN 56601-5644
Mailing AddressPo Box 1005Bemidji, MN 56619-1005 · (218) 751-4216 · Fax (218) 444-6057
Phone(218) 751-4216
Fax(218) 444-6057
Organization SubpartNo
Authorized OfficialDouglas R WilliamsOwner · (218) 751-4216
Enumeration DateApril 1, 2008
Last NPPES UpdateJune 11, 2008
✔ NPI 1821260654 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
3622 MOBERG DR NW, Bemidji, MN 56601
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Other Identifiers 1

Medicaid172820200MN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

BARET WILLIAMS-FURFARO
Dentist
3622 MOBERG DR NW
BEMIDJI, MN 56601
Beltrami County (218) 751-4216
MR. JACK RICHARD SAUER
Dentist
3622 MOBERG DR NW
BEMIDJI, MN 56601
Beltrami County (218) 751-4216
BAILEE JO JERGER MDT, RDH
Dental Therapist
3622 MOBERG DR NW
BEMIDJI, MN 56601
Beltrami County (507) 529-0436
GREAT RIVER DENTISTRY OF BEMIDJI, PLLC
Clinic/Center (Dental)
3622 MOBERG DR NW
BEMIDJI, MN 56601
Beltrami County (218) 751-4216

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 Great River Dentistry Of Bemidji, P.A.'s NPI number?

The NPI number for Great River Dentistry Of Bemidji, P.A. is 1821260654. It was assigned to this organization in the NPPES registry on April 1, 2008.

Where is Great River Dentistry Of Bemidji, P.A. located?

Great River Dentistry Of Bemidji, P.A. is located at 3622 Moberg Dr NW, Bemidji, MN 56601. The listed phone number is (218) 751-4216.

What is Great River Dentistry Of Bemidji, P.A.'s specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Great River Dentistry Of Bemidji, P.A. was last updated on June 11, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.