Northeast Dental, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7820 Issued in MN

Legal business name

NORTHEAST DENTAL, P.A.

Practice address

4520 Centerville Rd
Saint Paul, MN 55127-3602

Phone

(651) 426-4799

Fax

(651) 426-8106

NPI assigned

Apr 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert L Keifer, D.D.S.

Title

President

Phone

(651) 426-4799

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043435951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4520 CENTERVILLE RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551273602",
            "telephone_number": "651-426-4799",
            "fax_number": "651-426-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4520 CENTERVILLE RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551273602",
            "telephone_number": "651-426-4799",
            "fax_number": "651-426-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEIFER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-426-4799",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Point Health &Wellness Center
• North St Paul Chiropractic Office, P.a.
• North Star Counseling & Mediation Services PSC
• North Star Health Alliance, LLC
• North Suburban Optical
• Northern Medical Supply Co.
• Northern Stars Home Care LLC
• Northland Dental Partners, PLLC
• Northland Dental Partners, PLLC
• Northland Foot & Ankle Specialists

• All providers in Saint Paul, MN
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.