NPIMap

Organization Active NPI

Theresa M. Snell

  • Dental Clinic/Center
  • New Brighton, MN
National Provider Identifier
1033710025
Registry record updated Nov 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
THERESA M. SNELL
Practice address
580 5TH Ave NW Ste 100
New Brighton, MN 55112-2836
Phone
(651) 633-6087
NPI assigned
Nov 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2020

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

Authorized official

Name
Dr. Theresa M. Snell, DDSNPI 1750487815
Title
Owner
Phone
(651) 633-6087

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

580 5TH Ave NW Ste 100
New Brighton, MN 55112-2836

Mailing address

580 5TH Ave NW Ste 100
New Brighton, MN 55112-2836
Phone (651) 633-6087

Other names 1

  • Silver Lake Dental Doing business as

National Provider Directory

National Provider Directory

Locations

580 5th Ave NW
Ste 100
New Brighton, MN 55112
Phone (651) 633-6087

Practitioners & affiliated clinicians

Practitioners 3

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": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1033710025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 5TH AVE NW STE 100",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122836",
            "telephone_number": "651-633-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 5TH AVE NW STE 100",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551122836",
            "telephone_number": "651-633-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA M. SNELL",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "SNELL",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-633-6087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Silver Lake Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in New Brighton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.