Silver Lake Smiles Family Dentistry

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SILVER LAKE SMILES FAMILY DENTISTRY

Practice address

2370 Palmer Drive
New Brighton, MN 55112

Phone

(651) 356-5424

NPI assigned

Jun 27, 2019

Organization subpart

No

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

Authorized official

Name

David OngNPI 1114180460

Title

Owner

Phone

(651) 356-5424

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David A Ong, DDS

  • General Practice Dentistry
  • New Brighton, MN
  • NPI 1114180460
  NPD (past) Authorized official

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

{
    "created_epoch": "1561593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580947200000",
    "number": "1205497435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 PALMER DRIVE",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-356-5424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 PALMER DRIVE",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "651-356-5424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SILVER LAKE SMILES FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-27",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A",
        "authorized_official_last_name": "ONG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-356-5424"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@silverlakesmile.com",
            "affiliation": "N",
            "address_1": "5482 Bald Eagle Blvd E",
            "city": "White Bear Township",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551102304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eric Shedd, LADC
• Justin Shedivy
• Zach Shivers, RDN
• Jay Scott Sidor, LMFT
• Silver Lake Chiropractic Inc
• Silver Lake Transportation, LLC
• Silvercrest Properties, LLC
• Larry Silverness
• Stacy Smith Donley, MA, LMFT
• Ernest Garnark Smith Jr.

• Dental Clinic/Center in New Brighton, MN
• Providers in New Brighton, 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 Feb 6, 2020; 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.