NPIMap

Organization Active NPI

Pepin Valley Dental

  • Dental Clinic/Center
  • Lake City, MN
National Provider Identifier
1114188307
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
9591 Issued in MN
Legal business name
PEPIN VALLEY DENTAL
Practice address
1350 N 7TH St
Lake City, MN 55041-1251
Phone
(651) 345-3023
Fax
(651) 345-3064
NPI assigned
Jun 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Authorized official

Name
Stephen Brown, D.D.S.NPI 1124189444
Title
President
Phone
(651) 345-3023

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 9591 MN Primary

Addresses

Primary practice location

1350 N 7TH St
Lake City, MN 55041-1251

Mailing address

1350 N 7TH St
Lake City, MN 55041-1251
Phone (651) 345-3023

National Provider Directory

National Provider Directory

Locations

1350 N 7th St
Lake City, MN 55041
Phone (651) 345-3023

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294099200000",
    "number": "1114188307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 N 7TH ST",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411251",
            "telephone_number": "651-345-3023",
            "fax_number": "651-345-3064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 N 7TH ST",
            "city": "LAKE CITY",
            "state": "MN",
            "postal_code": "550411251",
            "telephone_number": "651-345-3023",
            "fax_number": "651-345-3064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEPIN VALLEY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-19",
        "last_updated": "2011-01-04",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-345-3023",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "9591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 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.