Red Oak Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RED OAK FAMILY DENTAL

Practice address

9939 Hudson Blvd N # 107
Lake Elmo, MN 55042-4109

Phone

(651) 300-2334

NPI assigned

May 31, 2019

Organization subpart

No

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

Authorized official

Name

Katrina Andrada Leano, DDSNPI 1427241173

Title

Dentist/Owner

Phone

(651) 226-1029

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Katrina Andrada Leano, D.D.S.

  • General Practice Dentistry
  • Vadnais Heights, MN
  • NPI 1427241173
  NPD (past) Authorized official

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559260800000",
    "number": "1154989507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9090 RED OAK TRL",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551292210",
            "telephone_number": "651-226-1029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9939 HUDSON BLVD N # 107",
            "city": "LAKE ELMO",
            "state": "MN",
            "postal_code": "550424109",
            "telephone_number": "651-300-2334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED OAK FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-05-31",
        "status": "A",
        "authorized_official_last_name": "LEANO",
        "authorized_official_first_name": "KATRINA",
        "authorized_official_middle_name": "ANDRADA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "651-226-1029",
        "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": []
}

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• Kya Rawn, LMFT
• Pang Foua Yang Rhodes, LMFT
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• Adam Ridgeway, DDS
• Andrea Susan Robertson, MSW, LICSW
• Victor Manuel Rodriguez

• General Practice Dentistry in Lake Elmo, MN
• Providers in Lake Elmo, 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 May 31, 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.