Dakota Children's Dentistry

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D10462 Issued in MN

Legal business name

DAKOTA CHILDREN'S DENTISTRY

Practice address

3410 151St St W
Rosemount, MN 55068-1755

Phone

(651) 322-5788

Fax

(651) 322-4257

NPI assigned

Nov 2, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel H Glenn, D.D.S, M.S.

Title

President

Phone

(651) 322-5788

Specialties & licenses 1

Addresses

Tax ID family

Dakota Children's Dentistry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Dakota Children's Dentistry

  • Pediatric Dentistry
  • Inver Grove Heights, MN
  • NPI 1811061054
  NPD tax ID

Locations

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.

• Kerry Gwen Johnson Winters, DDS

  • Pediatric Dentistry
  • Rosemount, MN
  • NPI 1871564195
  NPD (past)

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306924584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 151ST ST W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681755",
            "telephone_number": "651-322-5788",
            "fax_number": "651-322-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3410 151ST ST W",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550681755",
            "telephone_number": "651-322-5788",
            "fax_number": "651-322-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAKOTA CHILDREN'S DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-322-5788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S, M.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D10462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Philip Clemens
• Samantha Cline
• Katherine Corral
• Kirsten Curtis
• Trudy Dahl
• Dakota Unlimited, Inc,
• William Albert Danaher, MSW LGSW
• Tichina Lashay Davis
• Abbie Dechamps
• Bethani Demmers

• Pediatric Dentistry in Rosemount, MN
• Providers in Rosemount, MN by specialty
• Pediatric Dentistry in Minnesota

• 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.