NPIMap

Organization Active NPI

G2 South PLLC

  • Dentist
  • Inver Grove Heights, MN
National Provider Identifier
1023127388
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
G2 SOUTH PLLC
Practice address
5846 Blackshire Path
Inver Grove Heights, MN 55076
Phone
(651) 389-1133
Fax
(651) 464-1135
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Tracey Michelle Koch
Title
Practice Director
Phone
(651) 464-2248

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X MN Primary

Addresses

Primary practice location

5846 Blackshire Path
Inver Grove Heights, MN 55076

Mailing address

5846 Blackshire Path
Inver Grove Heights, MN 55076
Phone (651) 389-1133

National Provider Directory

National Provider Directory
Tax ID family
G2 South2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1023127388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5846 BLACKSHIRE PATH",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "55076",
            "telephone_number": "651-389-1133",
            "fax_number": "651-389-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5846 BLACKSHIRE PATH",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "55076",
            "telephone_number": "651-389-1133",
            "fax_number": "651-464-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G2 SOUTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "KOCH",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PRACTICE DIRECTOR",
        "authorized_official_telephone_number": "651-464-2248"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Inver Grove Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.