IDEAL IMAGE DENTISTRY & SPA NPI 1891090668

NPI Information

NPI: 1891090668
Provider Name: IDEAL IMAGE DENTISTRY & SPA
Classification: Dentist - 1223G0001X
Specialization: General Practice
Entity Type: Organization
Address: 1008 E MAIN ST
MANDAN, ND
ZIP 58554
Phone: (701) 667-1933

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NPI Details

IDEAL IMAGE DENTISTRY & SPA is a general practice dentist in Mandan, ND. The provider is 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. IDEAL IMAGE DENTISTRY & SPA NPI is 1891090668. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1008 E MAIN ST
MANDAN, ND
ZIP 58554-762
Phone: (701) 667-1933

The provider's authorized official is Fredrick A Landgrebe .
The authorized official title is Owner/dentist and has the following contact phone number (701) 667-1933.

The enumeration date for this NPI number is 1/25/2011 and was last updated on 1/25/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	1593	NORTH DAKOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	41545	MEDICAID	NORTH DAKOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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