Active NPI
Endodontic Professionals PA Plymouth Endodontics
- Endodontics
- Plymouth, MN
National Provider Identifier
1093908360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 1093720
- Legal business name
- ENDODONTIC PROFESSIONALS PA PLYMOUTH ENDODONTICS
- Practice address
- 3401 Hwy 169 N
Plymouth, MN 55441 - Phone
- (763) 559-0859
- Fax
- (763) 559-4356
- NPI assigned
- Aug 21, 2007
- Last updated
- Aug 21, 2007
- Organization subpart
- Yes
- Parent organization
- ENDODONTIC PROFESSIONALS PA
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Thomas A Karn, DMD
- Title
- Vice President
- Phone
- (763) 559-4356
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 1093720 | MN | Primary |
Addresses
Primary practice location
3401 Hwy 169 N
Plymouth, MN 55441
Mailing address
3401 Hwy 169 N
Plymouth, MN 55441
Phone (763) 559-0859
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
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.
-
- Endodontics
- Plymouth, MN
- NPI 1578638946
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187654400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187654400000",
"number": "1093908360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3401 HWY 169 N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "55441",
"telephone_number": "763-559-0859",
"fax_number": "763-559-4356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3401 HWY 169 N",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "55441",
"telephone_number": "763-559-0859",
"fax_number": "763-559-4356"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ENDODONTIC PROFESSIONALS PA PLYMOUTH ENDODONTICS",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "ENDODONTIC PROFESSIONALS PA",
"enumeration_date": "2007-08-21",
"last_updated": "2007-08-21",
"status": "A",
"authorized_official_last_name": "KARN",
"authorized_official_first_name": "THOMAS",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "763-559-4356",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Endodontics",
"state": "MN",
"license": "1093720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.