Op Orthodontics of Minnesota PLLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

OP ORTHODONTICS OF MINNESOTA PLLC

Practice address

250 Roosevelt St
Ironwood, MI 49938-1737

Phone

(218) 460-5417

NPI assigned

Dec 7, 2021

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• Carlson Orthodontics Doing business as

Tax ID family

Carlson Orthodontics3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Op Orthodontics of Minnesota PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Superior, WI
  • NPI 1356009302
  NPD tax ID
• Op Orthodontics of Minnesota PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Duluth, MN
  • NPI 1982363586
  NPD tax ID

Locations

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

{
    "created_epoch": "1638835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638835200000",
    "number": "1083372031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 ROOSEVELT ST",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499381737",
            "telephone_number": "218-460-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 ROOSEVELT ST",
            "city": "IRONWOOD",
            "state": "MI",
            "postal_code": "499381737",
            "telephone_number": "218-460-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OP ORTHODONTICS OF MINNESOTA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-07",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Carlson Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Richard A Miller, OD
• J Michael Nelson, D.O.
• Heather Kirsten Nyman, NP-C
• Obidike M Olisa, MD
• Victoria Oliver, PHARMD
• Brianna Peige Orr, FNP-C
• Jon Ross Pagel, PHARMD
• Eric J Paul, PTA
• Nicole Pietsch, PA-C
• Molly Pikka

• Orthodontics and Dentofacial Orthopedics Dentistry in Ironwood, MI
• Providers in Ironwood, MI by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2021; 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.