Amundson Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D12460 Issued in MN

Legal business name

AMUNDSON FAMILY DENTISTRY

Practice address

6939 Pine Arbor Dr S
Ste 104
Cottage Grove, MN 55016-4642

Phone

(651) 459-3514

Fax

(651) 459-4537

NPI assigned

May 15, 2013

Last updated

May 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa Kathleen Amundson, DDSNPI 1134317712

Title

Owner/Dentist

Phone

(651) 459-3514

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Lisa Kathleen Amundson, DDS

  • General Practice Dentistry
  • Cottage Grove, MN
  • NPI 1134317712
  Authorized official Same address or phone

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

{
    "created_epoch": "1368576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1043656168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6939 PINE ARBOR DR S",
            "address_2": "STE 104",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164642",
            "telephone_number": "651-459-3514",
            "fax_number": "651-459-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6939 PINE ARBOR DR S",
            "address_2": "STE 104",
            "city": "COTTAGE GROVE",
            "state": "MN",
            "postal_code": "550164642",
            "telephone_number": "651-459-3514",
            "fax_number": "651-459-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMUNDSON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-15",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "AMUNDSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "KATHLEEN",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "651-459-3514",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D12460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allina Health System (Allina Health Cottage Grove Pharmacy)
• Allina Health System (Allina Health Cottage Grove Clinic)
• Allina Health System (Allina Health Cottage Grove Pharmacy)
• Amaani House (Amira House)
• Amerigrace Home Care LLC
• Lisa Kathleen Amundson, DDS
• Tanya Marie Anderson, CCC-SLP
• Hillary Marie Andrews
• Craig Lyman Anshus, D.C.
• Martha Name Asare-Dokyi

• Dental Clinic/Center in Cottage Grove, MN
• Providers in Cottage Grove, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.