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NPI · 1124289905 · NPPES-sourced

Etern Park DDS, MD

ActiveOral and Maxillofacial Surgery (Dentist)
NPI Number
1124289905
Type 1 · Individual
Contact
(701) 234-2000
License NY · 053210
Last Updated
Enumerated
Primary practice addressND · 58103-4939
1717 University Dr SFargo, ND 58103-4939
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About this NPIWhat this record shows.

NPI 1124289905 is registered to Etern Park DDS, MD, a Oral and Maxillofacial Surgery (Dentist) practising at 1717 University Dr S in Fargo, North Dakota. Oral and Maxillofacial Surgery (Dentist) is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Etern Park DDS, MD has been enumerated in the National Provider Identifier (NPI) registry since 2008.

Provider type
Individual (Type 1)
Status
Active
Enumerated
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Medicare enrollment

This provider holds 2 Medicare enrollments on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Etern Park DDS, MD accepts. To confirm in-network status with your specific health plan, contact Etern Park DDS, MD directly at (701) 234-2000.

Frequently asked

Yes. NPI 1124289905 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Oral and Maxillofacial Surgery (Dentist) is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (701) 234-2000.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Etern Park DDS, MD is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy1223S0112X
Last updated
Enumerated
StatusActive
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1 record · same addressOther providers at this location.

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Same specialtyOther Oral and Maxillofacial Surgery (Dentist) providers in North Dakota.

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Adjacent in the NPPES enumeration sequenceNPIs enumerated around this one.

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