Highgrove Dental Care Apc

Primary specialty

DentistTaxonomy code 122300000X

License

D11119 Issued in MN

Legal business name

HIGHGROVE DENTAL CARE APC

Practice address

670 S Cleveland Ave
Saint Paul, MN 55116

Phone

(651) 698-3828

Fax

(651) 698-0864

NPI assigned

Aug 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Terry Michael O'Neill, DMD

Title

Owner Dentist

Phone

(651) 698-3828

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316050842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 S CLEVELAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55116",
            "telephone_number": "651-698-3828",
            "fax_number": "651-698-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 S CLEVELAND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55116",
            "telephone_number": "651-698-3828",
            "fax_number": "651-698-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIGHGROVE DENTAL CARE APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "O'NEILL",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "651-698-3828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Saint Paul, MN
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• Dentist 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.