NPIMap

Organization Active NPI

Basile Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Minnetonka, MN
National Provider Identifier
1194939041
Registry record updated Feb 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D10983 Issued in MN
Legal business name
BASILE ORTHODONTICS PA
Practice address
17809 Hutchins Drive
Suite 101
Minnetonka, MN 55345
Phone
(952) 474-3203
Fax
(952) 474-3204
NPI assigned
May 10, 2007
Last updated
Feb 17, 2009By the provider in NPPES
Organization subpart
Yes
Parent organization
BASILE ORTHODONTICS, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 17, 2009

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

Authorized official

Name
Dr. Joseph Samuel Basile III, D.D.S.NPI 1649484502
Title
Orthodontist
Phone
(952) 474-3203

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)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D10983 MN Primary

Addresses

Primary practice location

17809 Hutchins Drive
Suite 101
Minnetonka, MN 55345

Mailing address

17809 Hutchins Drive
Suite 101
Minnetonka, MN 55345
Phone (952) 474-3203

Other names 1

  • Minnetonka Lake Orthodontics Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Basile Orthodontics PA2 organizations share this tax ID, including this one
Part of
Basile Orthodontics PA

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234828800000",
    "number": "1194939041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17809 HUTCHINS DRIVE",
            "address_2": "SUITE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-474-3203",
            "fax_number": "952-474-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17809 HUTCHINS DRIVE",
            "address_2": "SUITE 101",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-474-3203",
            "fax_number": "952-474-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASILE ORTHODONTICS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BASILE ORTHODONTICS, P.A.",
        "enumeration_date": "2007-05-10",
        "last_updated": "2009-02-17",
        "status": "A",
        "authorized_official_last_name": "BASILE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "952-474-3203",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D10983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnetonka Lake Orthodontics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.