NPIMap

Organization Active NPI

Central Minnesota Pediatric Dentists PA

  • Pediatric Dentistry
  • Big Lake, MN
National Provider Identifier
1265873707
Registry record updated Jul 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
D11073 Issued in MN
Legal business name
CENTRAL MINNESOTA PEDIATRIC DENTISTS PA
Practice address
570 Humboldt Dr Ste 102
Big Lake, MN 55309-4844
Phone
(320) 253-0272
Fax
(320) 251-2661
NPI assigned
Jul 12, 2013
Last updated
Jul 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2013

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

Authorized official

Name
Dr. Michael W Steil, DDSNPI 1629018536
Title
Partner/Owner
Phone
(320) 253-0272

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X D7765 MN
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X D11073 MN Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X D11344 MN
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X D12885 MN

Addresses

Primary practice location

570 Humboldt Dr Ste 102
Big Lake, MN 55309-4844

Mailing address

1900 Centracare Cir Ste 350
Saint Cloud, MN 56303-5000
Phone (320) 253-0272

National Provider Directory

National Provider Directory
Tax ID family
Central Minnesota Pediatric Dentists PA5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

570 Humboldt Dr
Ste 102
Big Lake, MN 55309
Phone (320) 253-0272

Practitioners & affiliated clinicians

Practitioners 1

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": "1373587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373587200000",
    "number": "1265873707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 CENTRACARE CIR STE 350",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563035000",
            "telephone_number": "320-253-0272",
            "fax_number": "320-251-2661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 HUMBOLDT DR STE 102",
            "city": "BIG LAKE",
            "state": "MN",
            "postal_code": "553094844",
            "telephone_number": "320-253-0272",
            "fax_number": "320-251-2661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MINNESOTA PEDIATRIC DENTISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-12",
        "last_updated": "2013-07-12",
        "status": "A",
        "authorized_official_last_name": "STEIL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER/OWNER",
        "authorized_official_telephone_number": "320-253-0272",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D7765",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D11073",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D11344",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D12885",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Big Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; 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.