Four Seasons Dental PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FOUR SEASONS DENTAL PA

Doing business as

Four Seasons Dental PA

Practice address

4205 Lancaster LN N Ste 101
Plymouth, MN 55441-1702

Phone

(763) 559-2976

Fax

(763) 559-4852

NPI assigned

May 10, 2018

Organization subpart

No

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

Authorized official

Name

Kersten Hoffman

Title

Clinic Administrator

Phone

(952) 475-0225

Specialties & licenses 1

Addresses

Other names 1

• Four Seasons Dental PA Doing business as

Locations

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

{
    "created_epoch": "1525910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525910400000",
    "number": "1194215616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 BUSHAWAY RD STE 300",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553912079",
            "telephone_number": "952-475-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4205 LANCASTER LN N STE 101",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554411702",
            "telephone_number": "763-559-2976",
            "fax_number": "763-559-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR SEASONS DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-10",
        "last_updated": "2018-05-10",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "KERSTEN",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "952-475-0225"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Four Seasons Dental PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hannah Faith Foreman
• Callan Forgrave
• Shirley Ann Fors, AU.D
• Laura Fortner, MT-BC
• Sarah Anne Foster, MD.
• Four Seasons Family Chiropractic Clinic
• Cameron Fox, MD PHD
• Nova Frankel
• Sharde M Frazier
• Michael Q Freehill, M.D.

• Dental Clinic/Center in Plymouth, MN
• Providers in Plymouth, 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 May 10, 2018; 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.