Prosthodontic Associates, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D12653 Issued in MN

Legal business name

PROSTHODONTIC ASSOCIATES, PLLC

Practice address

2233 Hamline Ave N
Suite 210
Roseville, MN 55113-5009

Phone

(651) 633-4914

Fax

(651) 633-5126

NPI assigned

Apr 11, 2017

Last updated

Apr 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason Chong, DDSNPI 1023240074

Title

Partner

Phone

(651) 633-4914

Specialties & licenses 1

Addresses

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jason Chong, DDS

  • Prosthodontics
  • Minneapolis, MN
  • NPI 1023240074
  NPD (past) Authorized official
• Luis Fernando Delima Jr., D.D.S., F.A.C.P.

  • Prosthodontics
  • Edina, MN
  • NPI 1598997967
  NPD (past)
• Timothy A Peterson, DDS, MS

  • Prosthodontics
  • Minneapolis, MN
  • NPI 1477507119
  NPD (past)

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

{
    "created_epoch": "1491868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1164956694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N",
            "address_2": "SUITE 210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135009",
            "telephone_number": "651-633-4914",
            "fax_number": "651-633-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2233 HAMLINE AVE N",
            "address_2": "SUITE 210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135009",
            "telephone_number": "651-633-4914",
            "fax_number": "651-633-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSTHODONTIC ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-11",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "CHONG",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "651-633-4914",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D12653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Priebe
• Primecare Assistants (Primecare Assistants LLC)
• Carrie Pritzl III
• Procare Home Assistance
• Progress Valley, Inc.
• Jason Michael Prostrollo, D.O.
• Public Health Dental LLC
• Bernadette Putman, CCC-SLP
• Rasha Qasim
• Quality Home Care LLC

• Dental Clinic/Center in Roseville, MN
• Providers in Roseville, 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 Apr 11, 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.