Oak Park Dental - Pine City LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

OAK PARK DENTAL - PINE CITY LLC

Practice address

505 Johnson Ave SE
Pine City, MN 55063-2108

Phone

(320) 629-2282

NPI assigned

Jul 14, 2022

Organization subpart

No

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

Authorized official

Name

Genie Kuble

Title

Access Manager

Phone

(920) 450-0157

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1225762255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 JOHNSON AVE SE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550632108",
            "telephone_number": "320-329-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 JOHNSON AVE SE",
            "city": "PINE CITY",
            "state": "MN",
            "postal_code": "550632108",
            "telephone_number": "320-629-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK PARK DENTAL - PINE CITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-14",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "KUBLE",
        "authorized_official_first_name": "GENIE",
        "authorized_official_title_or_position": "ACCESS MANAGER",
        "authorized_official_telephone_number": "920-450-0157"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nilsson Chiropractic
• Joseph Norbert Nilsson, DC
• Lisa Elizabeth Nos-Tollefson, PSYD LPCC
• Nu Beginnings Psychological Services, PLLC
• Tamera Katherine O'Neill, MA, LPCC
• Oak Park Dental Clinic
• Bruce A Oleary, LMFT
• Lauren Olson, MS, LMFT
• Shannon Marie Olson, CNP
• Karen Lynn Overholser Hovland, RN, PHN

• General Practice Dentistry in Pine City, MN
• Providers in Pine City, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.