Just Kids Dental Inc

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

Legal business name

JUST KIDS DENTAL INC

Practice address

325 11TH Ave
Two Harbors, MN 55616-1300

Phone

(218) 206-4328

Fax

(218) 834-5533

NPI assigned

Apr 19, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Stacey Anderson, RDH

Title

Executive Director

Phone

(218) 206-4328

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1271635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271635200000",
    "number": "1013233873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556160146",
            "telephone_number": "218-206-4328",
            "fax_number": "218-834-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "325 11TH AVE",
            "city": "TWO HARBORS",
            "state": "MN",
            "postal_code": "556161300",
            "telephone_number": "218-206-4328",
            "fax_number": "218-834-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUST KIDS DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-19",
        "last_updated": "2010-04-19",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "STACEY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-206-4328",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RDH"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Two Harbors, MN
• Dental Hygienist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2010; 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.