Midwest Endodontics, P.a.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

7305 Issued in MN

Legal business name

MIDWEST ENDODONTICS, P.A.

Practice address

6949 Valley Creek Rd
#130
Woodbury, MN 55125-2253

Phone

(651) 731-1630

Fax

(651) 731-1635

NPI assigned

Apr 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William A. Gavin, D.D.S.NPI 1295856763

Title

Preident

Phone

(651) 731-1630

Specialties & licenses 1

Addresses

Locations

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.

• William Gavin, D.D.S.

  • Endodontics
  • Woodbury, MN
  • NPI 1295856763
  NPD (past) Authorized official

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205957776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6949 VALLEY CREEK RD",
            "address_2": "#130",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "651-731-1630",
            "fax_number": "651-731-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6949 VALLEY CREEK RD",
            "address_2": "#130",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551252253",
            "telephone_number": "651-731-1630",
            "fax_number": "651-731-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST ENDODONTICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PREIDENT",
        "authorized_official_telephone_number": "651-731-1630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "7305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Sharon Michaels, MD
• Travis Scott Michaels, MS, LPCC, NCC
• Marlen Midthune
• Midwest Ancillary Services, Inc (Midwest Hearing)
• Midwest Autism and Therapy Center of Iowa, LLC (Midwest Autism and Therapy Center of Minnesota)
• Midwest Eye Laboratories Woodbury LLC
• Midwest Minds Assessment and Therapy, PLLC (Midwest Minds)
• Midwest Surgery Center
• Midwest Surgery Center, LLC (Midwest Surgery Center- Woodbury)
• Alexa Jesse Miesbauer, PT, DPT

• Endodontics in Woodbury, MN
• Providers in Woodbury, MN by specialty
• Endodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.