NPIMap

Organization Active NPI

Harbor Dental PA

  • Dentist
  • Plymouth, MN
National Provider Identifier
1265595276
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D11435 Issued in MN
Legal business name
HARBOR DENTAL PA
Practice address
3001 Harbor Lane
Suite 100
Plymouth, MN 55447
Phone
(763) 553-0451
Fax
(763) 559-3425
NPI assigned
Dec 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Kathleen G Swanson, DDSNPI 1477672822
Title
DDS Owner
Phone
76355530451

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9384 MN
Dentist 122300000X D11435 MN Primary
Dentist 122300000X 9385 MN

Addresses

Primary practice location

3001 Harbor Lane
Suite 100
Plymouth, MN 55447

Mailing address

3001 Harbor Lane
Suite 100
Plymouth, MN 55447
Phone (763) 553-0451

Other names 1

  • Kathleen G Swanson DDS PA Former legal business name

National Provider Directory

National Provider Directory

Locations

3001 Harbor Ln N
Ste 100
Plymouth, MN 55447
Phone (763) 553-0451

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265595276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 HARBOR LANE",
            "address_2": "SUITE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55447",
            "telephone_number": "763-553-0451",
            "fax_number": "763-559-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HARBOR LANE",
            "address_2": "SUITE 100",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "55447",
            "telephone_number": "763-553-0451",
            "fax_number": "763-559-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SWANSON",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "DDS OWNER",
        "authorized_official_telephone_number": "76355530451",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "9384",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11435",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "9385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kathleen G Swanson DDS PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Plymouth, 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.