NPIMap

Organization Active NPI

West Side Community Health Service, Inc

  • Dental Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1144860685
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
WEST SIDE COMMUNITY HEALTH SERVICE, INC
Practice address
424 Dorothy Day Place
Saint Paul, MN 55102-1025
Phone
(651) 793-2219
NPI assigned
Jan 13, 2020
Last updated
May 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Authorized official

Name
Reuben Moore
Title
Ceo
Phone
(651) 602-7500

Specialties & licenses 1

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

Addresses

Primary practice location

424 Dorothy Day Place
Saint Paul, MN 55102-1025

Mailing address

153 Cesar Chavez St
Saint Paul, MN 55107-2226
Phone (651) 602-7500

Other names 1

  • Downtown Dental Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
West Side Community Health Service Inc22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

Locations

380 E Lafayette Frontage Rd
Saint Paul, MN 55107

NPI Registry JSON

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

{
    "created_epoch": "1578873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715731200000",
    "number": "1144860685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 CESAR CHAVEZ ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551072226",
            "telephone_number": "651-602-7500",
            "fax_number": "651-602-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 DOROTHY DAY PLACE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551021025",
            "telephone_number": "651-793-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SIDE COMMUNITY HEALTH SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-13",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-602-7500"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Downtown Dental Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

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