NPIMap

Organization Active NPI

Champlin Dentistry, PC

Doing business as Champlin Dentistry

  • General Practice Dentistry
  • Champlin, MN
National Provider Identifier
1194198309
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
CHAMPLIN DENTISTRY, PC
Doing business as
Champlin Dentistry
Practice address
11231 Aquila Drive N
Champlin, MN 55316
Phone
(763) 275-1318
Fax
(763) 400-9184
NPI assigned
Nov 10, 2015
Last updated
Nov 10, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Authorized official

Name
Dr. Paul S Gebhart, DDS
Title
Owner
Phone
(763) 275-1318

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X Primary

Addresses

Primary practice location

11231 Aquila Drive N
Champlin, MN 55316

Mailing address

17000 Red Hill Ave
Irvine, CA 92614-5626
Phone (714) 845-8890

Other names 1

  • Champlin Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

11231 Aquila Dr N
Champlin, MN 55316
Phone (763) 275-1318

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1447113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447113600000",
    "number": "1194198309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 RED HILL AVE",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926145626",
            "telephone_number": "714-845-8890",
            "fax_number": "949-474-1495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11231 AQUILA DRIVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "55316",
            "telephone_number": "763-275-1318",
            "fax_number": "763-400-9184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPLIN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A",
        "authorized_official_last_name": "GEBHART",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-275-1318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champlin Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Champlin, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2015; 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.