NPIMap

Organization Active NPI

Woodbury Endodontics, LLC

  • Endodontics
  • Woodbury, MN
National Provider Identifier
1205008661
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
D10211 Issued in MN
Legal business name
WOODBURY ENDODONTICS, LLC
Practice address
8401 Seasons Pkwy
Woodbury, MN 55125-3414
Phone
(651) 735-6430
Fax
(651) 735-6334
NPI assigned
Mar 26, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Authorized official

Name
Mitchell Lee Page, DDS, MS
Title
President of Woodbury Endodontics
Phone
(651) 735-6430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X D10211 MN Primary

Addresses

Primary practice location

8401 Seasons Pkwy
Woodbury, MN 55125-3414

Mailing address

8401 Seasons Pkwy
Woodbury, MN 55125-3414
Phone (651) 735-6430

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206489600000",
    "number": "1205008661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8401 SEASONS PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253414",
            "telephone_number": "651-735-6430",
            "fax_number": "651-735-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8401 SEASONS PKWY",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253414",
            "telephone_number": "651-735-6430",
            "fax_number": "651-735-6334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODBURY ENDODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2008-03-26",
        "status": "A",
        "authorized_official_last_name": "PAGE",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT OF WOODBURY ENDODONTICS",
        "authorized_official_telephone_number": "651-735-6430",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "D10211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.