Endodontic Professionals PA Arbor Lakes Endodontics

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

6500003 Issued in MN

Legal business name

ENDODONTIC PROFESSIONALS PA ARBOR LAKES ENDODONTICS

Practice address

12000 Elm Creek Blvd
Suite 240
Maple Grove, MN 55369

Phone

(763) 416-3619

Fax

(763) 416-3695

NPI assigned

Aug 21, 2007

Organization subpart

Yes

Parent organization

ENDODONTIC PROFESSIONALS PAAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Thomas A Karn, DMD

Title

Vice President

Phone

(763) 416-3619

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1003009374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12000 ELM CREEK BLVD",
            "address_2": "SUITE 240",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-416-3619",
            "fax_number": "763-416-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 ELM CREEK BLVD",
            "address_2": "SUITE 240",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "55369",
            "telephone_number": "763-416-3619",
            "fax_number": "763-416-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDODONTIC PROFESSIONALS PA ARBOR LAKES ENDODONTICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ENDODONTIC PROFESSIONALS PA",
        "enumeration_date": "2007-08-21",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "KARN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "763-416-3619",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "6500003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ellie Family Services, PLLP
• Joshua James Elliott, PT, DPT
• Thomas Wilks Ellis III, P.A. C
• Elm Creek Dental
• Callie Elmore
• Stephanie Endres, RN
• Evan Jon Endsley, DDS
• Kara Ann Engebretson, LICSW
• Richard Engleka, PHARMD
• William English, LP

• Endodontics in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Endodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.