NPIMap

Organization Active NPI

Lee Prohofsky DDS PA

  • General Practice Dentistry
  • Rogers, MN
National Provider Identifier
1215097134
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10843 Issued in MN
Legal business name
LEE PROHOFSKY DDS PA
Practice address
14000 Northdale Blvd Ste J
Rogers, MN 55374-4663
Phone
(763) 428-2300
Fax
(763) 428-4031
NPI assigned
Dec 11, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Lee Steven Prohofsky, D.D.S.NPI 1194885095
Title
President,Owner
Phone
(763) 428-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 10843 MN Primary

Addresses

Primary practice location

14000 Northdale Blvd Ste J
Rogers, MN 55374-4663

Mailing address

14000 Northdale Blvd Ste J
Rogers, MN 55374-4663
Phone (763) 428-2300

Other names 1

  • Turtle Cove Dental Doing business as

National Provider Directory

National Provider Directory

Locations

14000 Northdale Blvd
Ste J
Rogers, MN 55374
Phone (763) 428-2300

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215097134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14000 NORTHDALE BLVD STE J",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744663",
            "telephone_number": "763-428-2300",
            "fax_number": "763-428-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14000 NORTHDALE BLVD STE J",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744663",
            "telephone_number": "763-428-2300",
            "fax_number": "763-428-4031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE PROHOFSKY DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROHOFSKY",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "PRESIDENT,OWNER",
        "authorized_official_telephone_number": "763-428-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Turtle Cove Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rogers, MN

Sources for this page

  • 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.