Avon Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

AVON DENTAL PLLC

Practice address

308A Blattner Dr
Avon, MN 56310-8674

Phone

(320) 356-7374

NPI assigned

Nov 18, 2024

Organization subpart

No

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

Authorized official

Name

Nicolette Therese Porttiin, DDSNPI 1457972770

Title

President

Phone

(952) 686-8444

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Nicolette Therese Porttiin, DDS

  • Dentist
  • Avon, MN
  • NPI 1457972770
  NPD Authorized official

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1144045840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24183 69TH AVE",
            "city": "SAINT AUGUSTA",
            "state": "MN",
            "postal_code": "563018402",
            "telephone_number": "952-686-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308A BLATTNER DR",
            "city": "AVON",
            "state": "MN",
            "postal_code": "563108674",
            "telephone_number": "320-356-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVON DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "PORTTIIN",
        "authorized_official_first_name": "NICOLETTE",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-686-8444",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avon Dental Clinic PA
• Kathleen Alice Beuning, CNP
• Preston Bryant
• Central Minnesota Alarms, Inc,
• Alyssa Lynn Gullickson, D.D.S.
• Rebecca J Hafner-Fogarty, M.D.

• Dental Clinic/Center in Avon, MN
• Providers in Avon, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.