Carousel Pediatric Dentistry PLLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

CAROUSEL PEDIATRIC DENTISTRY PLLC

Practice address

15160 Foliage Ave Ste 110
Apple Valley, MN 55124-5916

Phone

(952) 715-6177

NPI assigned

Dec 23, 2020

Last updated

Dec 23, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Nordeen, DDSNPI 1538470711

Title

Owner

Phone

(952) 715-6177

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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.

• Kyle Nordeen, DDS

  • Pediatric Dentistry
  • Apple Valley, MN
  • NPI 1538470711
  NPD Authorized official
• Katherine Anne Nordeen, D.D.S.

  • Pediatric Dentistry
  • Apple Valley, MN
  • NPI 1558672733
  NPD

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

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1114514205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15160 FOLIAGE AVE STE 110",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245916",
            "telephone_number": "952-715-6177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15160 FOLIAGE AVE STE 110",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551245916",
            "telephone_number": "952-715-6177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROUSEL PEDIATRIC DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "NORDEEN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-715-6177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Apple Valley, MN
• Providers in Apple Valley, MN by specialty
• Pediatric Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; 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.