NPIMap

Organization Active NPI

Persona Dental P.C.

  • Dentist
  • Sartell, MN
National Provider Identifier
1316118839
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10419 Issued in MN
Legal business name
PERSONA DENTAL P.C.
Practice address
2385 Troop Dr
Suite 201
Sartell, MN 56377
Phone
(320) 251-2972
Fax
(320) 255-5514
NPI assigned
Mar 13, 2008
Last updated
Jun 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Tammy M Hines, CDA, RDA
Title
Office Coordinator
Phone
(320) 251-2972

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10419 MN Primary

Addresses

Primary practice location

2385 Troop Dr
Suite 201
Sartell, MN 56377

Mailing address

2385 Troop Dr
Suite 201
Sartell, MN 56377
Phone (320) 251-2972

National Provider Directory

National Provider Directory

Locations

2385 Troop Dr
Unit 201
Sartell, MN 56377
Phone (320) 251-2972

Practitioners & affiliated clinicians

Practitioners 4

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": "1205366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1316118839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 TROOP DR",
            "address_2": "SUITE 201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-251-2972",
            "fax_number": "320-255-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 TROOP DR",
            "address_2": "SUITE 201",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-251-2972",
            "fax_number": "320-255-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONA DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-13",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "HINES",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE COORDINATOR",
        "authorized_official_telephone_number": "320-251-2972",
        "authorized_official_credential": "CDA, RDA"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "10419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sartell, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.