MSP Dentistry Inc

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

D12034 Issued in MN

Legal business name

MSP DENTISTRY INC

Practice address

13650 Hanson Blvd.
Suite #110
Andover, MN 55304

Phone

(763) 421-7900

Fax

(763) 421-7916

NPI assigned

Aug 15, 2017

Organization subpart

Yes

Parent organization

MSP DENTISTRY INC.As reported in NPPES

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

Authorized official

Name

Majid Fehresti, DDS

Title

Owner/DDS

Phone

(763) 421-7900

Specialties & licenses 1

Addresses

Other names 1

• Twin Cities Dental Doing business as

Tax ID family

MSP Dentistry Inc2 organizations share this tax ID, including this one

Part of

MSP Dentistry Inc

Other organizations with this tax ID 1

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

• MSP Dentistry, Inc.

  • Preferred Provider Organization
  • Champlin, MN
  • NPI 1558719922
  NPD tax ID

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• MSP Dentistry, Inc.

  • Preferred Provider Organization
  • Champlin, MN
  • NPI 1558719922
  NPPES parent name

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1502755200000",
    "number": "1124544895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13650 HANSON BLVD.",
            "address_2": "SUITE #110",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "55304",
            "telephone_number": "763-421-7900",
            "fax_number": "763-421-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13650 HANSON BLVD.",
            "address_2": "SUITE #110",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "55304",
            "telephone_number": "763-421-7900",
            "fax_number": "763-421-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MSP DENTISTRY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MSP DENTISTRY INC.",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A",
        "authorized_official_last_name": "FEHRESTI",
        "authorized_official_first_name": "MAJID",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "763-421-7900",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MN",
            "license": "D12034",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Twin Cities Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mikayla Money
• Moore Therapies, PLLC
• Brian Moore, LPCC
• Kathleen D Moore, MA, CCC-SLP
• Nicole Morrissey
• Evelyn L Mueggenberg, MS OT/L
• Anne Catherine Mugaas, M.S. CCC-SLP
• Kathy G Mulier, O.D.
• Jordan Myhre, MA, LPCC
• Natjek Health Care Services, LLC

• Preferred Provider Organization in Andover, MN
• Providers in Andover, MN by specialty
• Preferred Provider Organization in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; 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.