NPIMap

Organization Active NPI

Young at Heart Dentistry

  • Dentist
  • Alexandria, MN
National Provider Identifier
1063841559
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11247 Issued in MN
Legal business name
YOUNG AT HEART DENTISTRY
Practice address
111 10TH Ave E
Alexandria, MN 56308-1857
Phone
(320) 763-3113
Fax
(320) 759-1401
NPI assigned
Nov 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Authorized official

Name
Dr. Rick Darin Thiery, DDSNPI 1083734602
Title
Doctor/Dentist Owner
Phone
(320) 763-3113

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 11247 MN Primary

Addresses

Primary practice location

111 10TH Ave E
Alexandria, MN 56308-1857

Mailing address

111 10TH Ave E
Alexandria, MN 56308-1857
Phone (320) 763-3113

National Provider Directory

National Provider Directory

Locations

111 10th Ave E
Alexandria, MN 56308
Phone (320) 763-3113

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1063841559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 10TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081857",
            "telephone_number": "320-763-3113",
            "fax_number": "320-759-1401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 10TH AVE E",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563081857",
            "telephone_number": "320-763-3113",
            "fax_number": "320-759-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YOUNG AT HEART DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "THIERY",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "DARIN",
        "authorized_official_title_or_position": "DOCTOR/DENTIST OWNER",
        "authorized_official_telephone_number": "320-763-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "11247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.