Emergency Dental Professionals, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

EMERGENCY DENTAL PROFESSIONALS, LLC

Doing business as

Emergency Dental Professionals

Practice address

393 Dunlap St N Ste 308
Saint Paul, MN 55104-4223

Phone

(651) 788-7045

NPI assigned

Jun 20, 2022

Organization subpart

No

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

Authorized official

Name

Dr. David Park, DMD

Title

Ceo/President

Phone

(651) 788-7045

Specialties & licenses 1

Addresses

Other names 1

• Emergency Dental Professionals Doing business as

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1033840160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 DUNLAP ST N STE 308",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044223",
            "telephone_number": "651-788-7045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "393 DUNLAP ST N STE 308",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044223",
            "telephone_number": "651-788-7045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMERGENCY DENTAL PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "651-788-7045",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emergency Dental Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.