NPIMap

Organization Active NPI

Family and Cosmetic Gentle Dentistry

  • Dental Clinic/Center
  • New Hope, MN
National Provider Identifier
1023414174
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
FAMILY AND COSMETIC GENTLE DENTISTRY
Practice address
7500 42ND Ave N
New Hope, MN 55427-1225
Phone
(763) 533-0055
NPI assigned
Nov 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Authorized official

Name
Robert Luther Bodin, DDSNPI 1033109061
Title
Ceo/Owner
Phone
(952) 224-9783

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

7500 42ND Ave N
New Hope, MN 55427-1225

Mailing address

4100 Shoreline Dr
#4
Spring Park, MN 55384-4508
Phone (952) 224-9783

National Provider Directory

National Provider Directory
Tax ID family
Family and Cosmetic Gentle Dentistry16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

7500 42nd Ave N
New Hope, MN 55427
Phone (763) 252-6350

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416182400000",
    "number": "1023414174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 SHORELINE DR",
            "address_2": "#4",
            "city": "SPRING PARK",
            "state": "MN",
            "postal_code": "553844508",
            "telephone_number": "952-224-9783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 42ND AVE N",
            "city": "NEW HOPE",
            "state": "MN",
            "postal_code": "554271225",
            "telephone_number": "763-533-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND COSMETIC GENTLE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-11-17",
        "status": "A",
        "authorized_official_last_name": "BODIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LUTHER",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "952-224-9783",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hope, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.