Active NPI
Neda Falak
- General Practice Dentistry
- Prior Lake, MN
National Provider Identifier
1003039595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D11150
- Practice address
- 16250 Duluth Ave SE Ste 200
Prior Lake, MN 55372-2883 - Phone
- (952) 447-4463
- NPI assigned
- Apr 11, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 11150 | MN | |
| General Practice Dentistry | 1223G0001X | D11150 | MN | Primary |
Addresses
Primary practice location
16250 Duluth Ave SE Ste 200
Prior Lake, MN 55372-2883
Mailing address
16250 Duluth Ave SE Ste 200
Prior Lake, MN 55372-2883
Phone (952) 447-4463
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11150 | MN | MD | General Practice Dentistry |
| 11150 | MN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Smile Design Family Dentistry | Past | Accepting new patients | |
| Modern Dental Professionals Minnesota PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Eagan, MN
- NPI 1255639696
-
- Dentist
- Eagan, MN
- NPI 1437369105
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708646400000",
"number": "1003039595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16250 DULUTH AVE SE STE 200",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553722883",
"telephone_number": "952-447-4463"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16250 DULUTH AVE SE STE 200",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553722883",
"telephone_number": "952-447-4463"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FALAK",
"first_name": "NEDA",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-11",
"last_updated": "2024-02-23",
"certification_date": "2024-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "11150",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MN",
"license": "D11150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prior Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.