Organization Active NPI

Dinkytown Optical

  • Eyewear Supplier
  • Minneapolis, MN
National Provider Identifier
1003961327
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
DINKYTOWN OPTICAL
Practice address
1304 4TH St SE
Minneapolis, MN 55414-2029
Phone
(612) 331-7100
Fax
(612) 331-7100
NPI assigned
Jan 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Larry Zidel
Title
Owner
Phone
(612) 331-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

1304 4TH St SE
Minneapolis, MN 55414-2029

Mailing address

1304 4TH St SE
Minneapolis, MN 55414-2029
Phone (612) 331-7100

Other identifiers 2

IdentifierTypeStateIssuer
13307PAOtherMNBCBS OF MN
1001127OtherMNPREFERRED ONE

National Provider Directory

National Provider Directory

Locations

1304 4th St SE
Minneapolis, MN 55414
Phone (612) 331-7100

Practitioners & affiliated clinicians

Practitioners 1

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003961327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 4TH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142029",
            "telephone_number": "612-331-7100",
            "fax_number": "612-331-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 4TH ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554142029",
            "telephone_number": "612-331-7100",
            "fax_number": "612-331-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DINKYTOWN OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZIDEL",
        "authorized_official_first_name": "LARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-331-7100"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "13307PA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "1001127",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.