Creekside Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

CREEKSIDE DENTAL PLLC

Practice address

3340 Republic Ave Ste 130
St Louis Park, MN 55426-4189

Phone

(763) 442-7624

NPI assigned

May 1, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Gabriel De Los Rios, DDSNPI 1265086011

Title

Owner/Dentist

Phone

(763) 442-7624

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.

• Gabriel Alberto De Los Rios, DDS

  • Dentist
  • St Louis Park, MN
  • NPI 1265086011
  NPD Authorized official

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

{
    "created_epoch": "1651363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651363200000",
    "number": "1043955412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12445 PORCUPINE CT",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443972",
            "telephone_number": "612-327-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 REPUBLIC AVE STE 130",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554264189",
            "telephone_number": "763-442-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-01",
        "last_updated": "2022-05-01",
        "certification_date": "2022-05-01",
        "status": "A",
        "authorized_official_last_name": "DE LOS RIOS",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "763-442-7624",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth B Cram, MD
• Jill Doreen Cramer, OT
• Kathryn Ann Crask, OTR/L
• Kathryn Elizabeth Crawford, FNP
• Creating Soulcial Connections LLC
• Crescent Transportation LLC
• Rose Alicia Crider, RD
• Amy B Criego, MD
• Stephanie H Critchley, RD
• Deborah May Croker, MD

• Dentist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.