NPIMap

Organization Active NPI

Family Orthodontic Specialists, PLC

Doing business as Woodlake Orthodontics Maple Grove

  • General Practice Dentistry
  • Maple Grove, MN
National Provider Identifier
1083357727
Registry record updated Apr 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY ORTHODONTIC SPECIALISTS, PLC
Doing business as
Woodlake Orthodontics Maple Grove
Practice address
13784 83Rd Way N
Maple Grove, MN 55369-7192
Phone
(763) 494-6612
NPI assigned
Apr 20, 2022
Last updated
Apr 20, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY ORTHODONTIC SPECIALISTS, PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 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 Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

13784 83Rd Way N
Maple Grove, MN 55369-7192

Mailing address

13784 83Rd Way N
Maple Grove, MN 55369-7192
Phone (763) 494-6612

Other names 1

  • Woodlake Orthodontics Maple Grove Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Orthodontic Specialists PLC10 organizations share this tax ID, including this one
Part of
Family Orthodontic Specialists PLC

Other organizations with this tax ID 9

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

Locations

13784 83rd Way N
Maple Grove, MN 55369
Phone (763) 494-6612

NPI Registry JSON

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

{
    "created_epoch": "1650412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650412800000",
    "number": "1083357727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13784 83RD WAY N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697192",
            "telephone_number": "763-494-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13784 83RD WAY N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553697192",
            "telephone_number": "763-494-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY ORTHODONTIC SPECIALISTS, PLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY ORTHODONTIC SPECIALISTS, PLC",
        "enumeration_date": "2022-04-20",
        "last_updated": "2022-04-20",
        "certification_date": "2022-04-20",
        "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": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodlake Orthodontics Maple Grove",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.