NPIMap

Organization Active NPI

Great River Endodontics

  • Endodontics
  • Monticello, MN
National Provider Identifier
1275034886
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
11880 Issued in MN
Legal business name
GREAT RIVER ENDODONTICS
Practice address
9381 Cedar St.
Monticello, MN 55362
Phone
(763) 295-2222
Fax
(763) 295-2249
NPI assigned
Feb 28, 2018
Last updated
Feb 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Authorized official

Name
Thomas Andrew Karn, DMDNPI 1578638946
Title
President
Phone
(320) 259-5078

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 11880 MN Primary

Addresses

Primary practice location

9381 Cedar St.
Monticello, MN 55362

Mailing address

622 Roosevelt Rd. Suite 180
St. Cloud, MN 56301
Phone (320) 259-5078

National Provider Directory

National Provider Directory
Tax ID family
Great River Endodontics PA4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

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": "1519776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1275034886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 ROOSEVELT RD. SUITE 180",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "56301",
            "telephone_number": "320-259-5078",
            "fax_number": "320-259-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9381 CEDAR ST.",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "55362",
            "telephone_number": "763-295-2222",
            "fax_number": "763-295-2249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-28",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "KARN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-259-5078",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": "11880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; 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.