Organization Active NPI

Advance Family Dental

  • Dental Clinic/Center
  • Vadnais Heights, MN
National Provider Identifier
1053591255
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
9142 Issued in MN
Legal business name
ADVANCE FAMILY DENTAL
Practice address
925 County Road E E
Suite 185
Vadnais Heights, MN 55127-7179
Phone
(651) 482-1122
Fax
(651) 766-2557
NPI assigned
Nov 6, 2007
Last updated
Nov 6, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Authorized official

Name
Molly Seidl
Title
Office Manager
Phone
(651) 482-1122

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 9142 MN Primary
Dental Clinic/Center 261QD0000X 12387 MN

Addresses

Primary practice location

925 County Road E E
Suite 185
Vadnais Heights, MN 55127-7179

Mailing address

925 County Road E E
Suite 185
Vadnais Heights, MN 55127-7179
Phone (651) 482-1122

National Provider Directory

National Provider Directory

Locations

925 County Road E E
Ste 185
Vadnais Heights, MN 55127
Phone (651) 482-1122

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1053591255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 COUNTY ROAD E E",
            "address_2": "SUITE 185",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277179",
            "telephone_number": "651-482-1122",
            "fax_number": "651-766-2557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 COUNTY ROAD E E",
            "address_2": "SUITE 185",
            "city": "VADNAIS HEIGHTS",
            "state": "MN",
            "postal_code": "551277179",
            "telephone_number": "651-482-1122",
            "fax_number": "651-766-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "SEIDL",
        "authorized_official_first_name": "MOLLY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-482-1122"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "9142",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "12387",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vadnais Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.