NPIMap

Organization Active NPI

Omega Dental Care, P.a.

  • Dental Clinic/Center
  • Eden Prairie, MN
National Provider Identifier
1003429515
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
OMEGA DENTAL CARE, P.A.
Practice address
6203 Dell Rd
Eden Prairie, MN 55346-1122
Phone
(952) 460-9100
NPI assigned
Aug 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Authorized official

Name
Dr. Annelle Soberay, DDSNPI 1487612750
Title
President
Phone
(952) 460-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

6203 Dell Rd
Eden Prairie, MN 55346-1122

Mailing address

1161 Wayzata Blvd E # 210
Wayzata, MN 55391-1935

National Provider Directory

National Provider Directory

Locations

6203 Dell Rd
Eden Prairie, MN 55346
Phone (952) 460-9100

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1598313600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598313600000",
    "number": "1003429515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 WAYZATA BLVD E # 210",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6203 DELL RD",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553461122",
            "telephone_number": "952-460-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OMEGA DENTAL CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-25",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A",
        "authorized_official_last_name": "SOBERAY",
        "authorized_official_first_name": "ANNELLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-460-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2020; 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.