NPIMap

Organization Active NPI

Minneapolis-St.Paul Endodontics

  • Endodontics
  • Woodbury, MN
National Provider Identifier
1104193762
Registry record updated Nov 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
MINNEAPOLIS-ST.PAUL ENDODONTICS
Practice address
10150 City Walk Dr Ste C
Woodbury, MN 55129
Phone
(651) 714-7111
Fax
(651) 714-9005
NPI assigned
Nov 28, 2011
Last updated
Nov 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2011

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

Authorized official

Name
Christa Miggler
Title
Practice Manager
Phone
(651) 439-2600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X Primary

Addresses

Primary practice location

10150 City Walk Dr Ste C
Woodbury, MN 55129

Mailing address

10150 City Walk Dr Ste C
Woodbury, MN 55129
Phone (651) 714-7111

National Provider Directory

National Provider Directory
Tax ID family
Minneapolis-St Paul Periodontics12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1322438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1104193762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10150 CITY WALK DR STE C",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55129",
            "telephone_number": "651-714-7111",
            "fax_number": "651-714-9005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10150 CITY WALK DR STE C",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55129",
            "telephone_number": "651-714-7111",
            "fax_number": "651-714-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNEAPOLIS-ST.PAUL ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-28",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "MIGGLER",
        "authorized_official_first_name": "CHRISTA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "651-439-2600"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; 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.