NPIMap

Organization Active NPI

Northland Dental Partners, PLLC

Doing business as Metro Dentalcare Roseville

  • General Practice Dentistry
  • Roseville, MN
National Provider Identifier
1043960776
Registry record updated Mar 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTHLAND DENTAL PARTNERS, PLLC
Doing business as
Metro Dentalcare Roseville
Practice address
2690 Snelling Ave N Ste 200
Roseville, MN 55113-1799
Phone
(651) 633-1834
Fax
(651) 633-0995
NPI assigned
Mar 25, 2022
Last updated
Mar 25, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHLAND DENTAL PARTNERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 25, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2690 Snelling Ave N Ste 200
Roseville, MN 55113-1799

Mailing address

2690 Snelling Ave N Ste 200
Roseville, MN 55113-1799
Phone (651) 633-1834

Other names 1

  • Metro Dentalcare Roseville Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northland Dental Partners43 organizations share this tax ID, including this one
Part of
Northland Dental Partners

Other organizations with this tax ID 42

Organizations that report the same tax identification number in the National Provider Directory.

View all 42

Locations

2690 Snelling Ave N
Ste 200
Roseville, MN 55113
Phone (651) 633-1834

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648166400000",
    "number": "1043960776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 SNELLING AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131799",
            "telephone_number": "651-633-1834",
            "fax_number": "651-633-0995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 SNELLING AVE N STE 200",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551131799",
            "telephone_number": "651-633-1834",
            "fax_number": "651-633-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "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": "Metro Dentalcare Roseville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.