Snelling Avenue Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7662 Issued in MN

Legal business name

SNELLING AVENUE DENTAL

Practice address

604 Snelling Ave S
Saint Paul, MN 55116-1528

Phone

(651) 699-5600

Fax

(651) 699-1966

NPI assigned

Jan 17, 2008

Organization subpart

No

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

Authorized official

Name

Charlene M Saice

Title

Office Manager

Phone

(651) 699-5600

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.

• Bernard L Bomberg, D.D.S.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1811956253
  NPD (past)

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1245416403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 SNELLING AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161528",
            "telephone_number": "651-699-5600",
            "fax_number": "651-699-1966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 SNELLING AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551161528",
            "telephone_number": "651-699-5600",
            "fax_number": "651-699-1966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SNELLING AVENUE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "SAICE",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-699-5600"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Smiths Medical MD Inc
• Angela JW Smithson, MD
• Mark Simon Sneider, MD
• Alexandra S Snell, APRN, FNP
• Rachel Snell, BSN, APN, WHCNP
• Laura Snow
• Ann Kathryn Snowbeck, LPCC, LADC
• Ellen B Snoxell, PH.D., L.P.
• Snyder Vision Optometrists PLLC
• Brian J Snyder, O.D.

• General Practice Dentistry in Saint Paul, MN
• Providers in Saint Paul, 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 Jun 26, 2008; 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.