Prior Lake

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D13230 Issued in MN

Legal business name

PRIOR LAKE

Practice address

14120 Commerce Ave
Suite #300
Prior Lake, MN 55372-5537

Phone

(952) 447-1080

Fax

(952) 447-0376

NPI assigned

Aug 24, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Steven Matthew Sarles, DDSNPI 1780025221

Title

Doctor

Phone

(952) 447-1080

Specialties & licenses 1

Addresses

Practitioners 2

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

• Steven Matthew Sarles, D.D.S.

  • General Practice Dentistry
  • Richfield, MN
  • NPI 1780025221
  NPD Authorized official
• Charles Walter Puffer, DDS

  • General Practice Dentistry
  • Prior Lake, MN
  • NPI 1508823139
  NPD (past)

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1083131643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14120 COMMERCE AVE NE STE 300",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721503",
            "telephone_number": "952-447-1080",
            "fax_number": "952-447-0376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14120 COMMERCE AVE",
            "address_2": "SUITE #300",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553725537",
            "telephone_number": "952-447-1080",
            "fax_number": "952-447-0376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIOR LAKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-24",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SARLES",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "952-447-1080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D13230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tara Ann Perttula, MSW
• Helen Jane Peterson, CNP
• Matthew Steven Pivec, PHARM.D.
• Pivotal Family Chiropractic LLC
• Katherine Price, OTR/L
• Prior Lake Natural Health Clinic
• Prior Lake Ops LLC (Keystone Prior Lake)
• Prior Lake Spine Health & Injury Center, PLLC (Prior Lake Spine)
• Prior Lake-Savage Independent School District #719
• Charles Walter Puffer, DDS

• Dental Clinic/Center in Prior Lake, MN
• Providers in Prior Lake, 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 Jul 21, 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.