NPIMap

Organization Active NPI

Main Street Dental

  • General Practice Dentistry
  • New Prague, MN
National Provider Identifier
1124150248
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MAIN STREET DENTAL
Practice address
301 Main St E
Suite 2
New Prague, MN 56071-1803
Phone
(952) 758-2376
Fax
(952) 758-8708
NPI assigned
Mar 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Paula Julie Novak
Title
Office Manager
Phone
(952) 758-2376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

301 Main St E
Suite 2
New Prague, MN 56071-1803

Mailing address

301 Main St E
Suite 2
New Prague, MN 56071-1803
Phone (952) 758-2376

National Provider Directory

National Provider Directory

Locations

301 Main St E
Ste 2
New Prague, MN 56071
Phone (952) 758-2376

Practitioners & affiliated clinicians

Practitioners 2

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": "1173657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124150248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAIN ST E",
            "address_2": "SUITE 2",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711803",
            "telephone_number": "952-758-2376",
            "fax_number": "952-758-8708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST E",
            "address_2": "SUITE 2",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711803",
            "telephone_number": "952-758-2376",
            "fax_number": "952-758-8708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "PAULA",
        "authorized_official_middle_name": "JULIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-758-2376",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Prague, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.