Active NPI
Montevideo Family Dentistry PA
- General Practice Dentistry
- Montevideo, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- MONTEVIDEO FAMILY DENTISTRY PA
- Practice address
- 629 Legion Dr Ste 2
Montevideo, MN 56265-1729 - Phone
- (320) 269-6416
- Fax
- (320) 269-8136
- NPI assigned
- Oct 27, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- James Kevin Zenk, DDS
- Title
- President Montevideo Family Dentist
- Phone
- (320) 269-6416
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
629 Legion Dr Ste 2
Montevideo, MN 56265-1729
Mailing address
629 Legion Dr Ste 2
Montevideo, MN 56265-1729
Phone (320) 269-6416
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 657524200 | Medicaid | MN |
National Provider Directory
National Provider Directory- Tax ID family
- Montevideo Family Dentistry PA
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- General Practice Dentistry
- Granite Falls, MN
- NPI 1790088680
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Dentist
- Montevideo, MN
- NPI 1952492035
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726531200000",
"number": "1194801910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 LEGION DR STE 2",
"city": "MONTEVIDEO",
"state": "MN",
"postal_code": "562651729",
"telephone_number": "320-269-6416",
"fax_number": "320-269-8136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 LEGION DR STE 2",
"city": "MONTEVIDEO",
"state": "MN",
"postal_code": "562651729",
"telephone_number": "320-269-6416",
"fax_number": "320-269-8136"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MONTEVIDEO FAMILY DENTISTRY PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-27",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A",
"authorized_official_last_name": "ZENK",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "KEVIN",
"authorized_official_title_or_position": "PRESIDENT MONTEVIDEO FAMILY DENTIST",
"authorized_official_telephone_number": "320-269-6416",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "657524200",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Montevideo, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.