NPIMap

Organization Active NPI

Dental Specialists of Minnesota, PLLC

Doing business as The Dental Specialist Minnetonka

  • Oral and Maxillofacial Surgery (Dentist)
  • Minnetonka, MN
National Provider Identifier
1003431263
Registry record updated Jun 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
DENTAL SPECIALISTS OF MINNESOTA, PLLC
Doing business as
The Dental Specialist Minnetonka
Practice address
14525 Highway 7 Ste 125
Minnetonka, MN 55345-3738
Phone
(952) 303-8858
Fax
(952) 314-4892
NPI assigned
Jun 13, 2020
Last updated
Jun 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2020

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

Authorized official

Name
Shannon Hesse
Title
Credentialing Specialists
Phone
(651) 746-2815

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

14525 Highway 7 Ste 125
Minnetonka, MN 55345-3738

Mailing address

2200 County Road C W Ste 2210
Roseville, MN 55113-2551
Phone (651) 746-2815

Other names 1

  • The Dental Specialist Minnetonka Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Specialists of Minnesota PLLC30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

14525 Highway 7
Ste 125
Minnetonka, MN 55345
Phone (952) 241-5860

NPI Registry JSON

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

{
    "created_epoch": "1592006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592006400000",
    "number": "1003431263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 COUNTY ROAD C W STE 2210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132551",
            "telephone_number": "651-746-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14525 HIGHWAY 7 STE 125",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453738",
            "telephone_number": "952-303-8858",
            "fax_number": "952-314-4892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALISTS OF MINNESOTA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-13",
        "last_updated": "2020-06-13",
        "certification_date": "2020-06-13",
        "status": "A",
        "authorized_official_last_name": "HESSE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALISTS",
        "authorized_official_telephone_number": "651-746-2815"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dental Specialist Minnetonka",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.