Individual provider Active NPI

Quintarias Terell Lester, DDS

  • Dental Clinic/Center
  • Saint Michael, MN
National Provider Identifier
1235621863
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D14323 Issued in MN
Practice address
654 Central Ave E
Saint Michael, MN 55376-9632
Phone
(763) 703-7529
NPI assigned
May 30, 2018
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D14323 MN Primary
Dentist 122300000X 00000 GA

Addresses

Primary practice location

654 Central Ave E
Saint Michael, MN 55376-9632

Mailing address

654 Central Ave E
Saint Michael, MN 55376-9632
Phone (637) 703-7529

Other identifiers 1

IdentifierTypeStateIssuer
UNKNOWNOtherUNKNOWN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
00000GAMDBehavior Technician
D14323MNMDDental Clinic/Center

Practice roles

OrganizationSpecialtyStatusNew patients
Milk and Honey Dental PLLC Dental Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1235621863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 CENTRAL AVE E",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769632",
            "telephone_number": "637-703-7529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 CENTRAL AVE E",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769632",
            "telephone_number": "763-703-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LESTER",
        "first_name": "QUINTARIAS",
        "middle_name": "TERELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D14323",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "00000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNKNOWN",
            "identifier": "UNKNOWN",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Michael, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.