NPIMap

Organization Active NPI

Today'S Dental St.Cloud SC

  • Point of Service
  • Brooklyn Park, MN
National Provider Identifier
1174913339
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
D12960 Issued in MN
Legal business name
TODAY'S DENTAL ST.CLOUD SC
Practice address
7960 Brooklyn Blvd
Brooklyn Park, MN 55445-2722
Phone
(763) 710-9937
Fax
(763) 710-9968
NPI assigned
Jan 27, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Authorized official

Name
Crystal Roehlke
Title
Office Manager
Phone
(320) 774-2557

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X D12960 MN Primary

Addresses

Primary practice location

7960 Brooklyn Blvd
Brooklyn Park, MN 55445-2722

Mailing address

4128 2ND St S
Saint Cloud, MN 56301-3704
Phone (320) 774-2557

National Provider Directory

National Provider Directory

Locations

4128 2nd St S
Saint Cloud, MN 56301
Phone (320) 774-2557

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1422316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1174913339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 2ND ST S",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563013704",
            "telephone_number": "320-774-2557",
            "fax_number": "763-710-9968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7960 BROOKLYN BLVD",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554452722",
            "telephone_number": "763-710-9937",
            "fax_number": "763-710-9968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TODAY'S DENTAL ST.CLOUD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-27",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A",
        "authorized_official_last_name": "ROEHLKE",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "320-774-2557"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "MN",
            "license": "D12960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.