Gentle Dentistry of Bloomington PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GENTLE DENTISTRY OF BLOOMINGTON PLLC

Practice address

10611 France Ave S Ste 201
Bloomington, MN 55431-3554

Phone

(952) 881-8404

NPI assigned

Sep 19, 2019

Organization subpart

No

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

Authorized official

Name

Robert L Bodin, DDS

Title

President

Phone

(952) 881-8404

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1154971380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 FRANCE AVE S STE 201",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313554",
            "telephone_number": "952-881-8404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 FRANCE AVE S STE 201",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554313554",
            "telephone_number": "952-881-8404"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1714 Cope Ave E",
            "address_purpose": "LOCATION",
            "city": "Maplewood",
            "state": "MN",
            "postal_code": "551092664",
            "country_code": "US",
            "telephone_number": "651-770-0055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GENTLE DENTISTRY OF BLOOMINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "BODIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-881-8404",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deko B Gelle
• Fathi Abdikarim Gelle
• General Care LLC
• Todd Roger Gengerke, M.D.
• Nevil Nuvala Genjang
• Gentle Guardians LLC
• Gideon H George
• Gerald a Madir
• Nathaniel Gerdes
• Geritom Med Inc

• General Practice Dentistry in Bloomington, MN
• Providers in Bloomington, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.