Organization Active NPI

V Dental Center

  • Pediatric Dentistry
  • Coon Rapids, MN
National Provider Identifier
1013111202
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D10987 Issued in MN
Legal business name
V DENTAL CENTER
Practice address
3903 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2520
Phone
(763) 422-2000
Fax
(763) 427-5770
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Lewis T. Yang
Title
Office Manager
Phone
(763) 422-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D10820 MN
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X D10987 MN Primary

Addresses

Primary practice location

3903 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2520

Mailing address

3903 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2520
Phone (763) 422-2000

Other names 1

  • V DENTAL INC. Former legal business name

National Provider Directory

National Provider Directory

Locations

3903 Coon Rapids Blvd NW
Coon Rapids, MN 55433
Phone (763) 422-2000

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": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1013111202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3903 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332520",
            "telephone_number": "763-422-2000",
            "fax_number": "763-427-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332520",
            "telephone_number": "763-422-2000",
            "fax_number": "763-427-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "V DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "YANG",
        "authorized_official_first_name": "LEWIS",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "763-422-2000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10820",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D10987",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "V DENTAL INC.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.