Crystal Dental Care Inc

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

CRYSTAL DENTAL CARE INC

Doing business as

Crystal Dental Care Inc

Practice address

5640 W Broadway Ave
Crystal, MN 55428-3556

Phone

(176) 353-7365

NPI assigned

Apr 11, 2022

Last updated

Apr 11, 2022By 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. Kimberlee Murphy, DDSNPI 1285706317

Title

Owner

Phone

(763) 537-3655

Specialties & licenses 1

Addresses

Other names 1

• CRYSTAL DENTAL CARE INC Doing business as

Electronic endpoints 1

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.

• Kimberlee Marie Murphy, DDS

  • General Practice Dentistry
  • Crystal, MN
  • NPI 1285706317
  NPD Authorized official

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

{
    "created_epoch": "1649635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649635200000",
    "number": "1316689201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5640 W BROADWAY AVE",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283556",
            "telephone_number": "176-353-7365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5640 W BROADWAY AVE",
            "city": "CRYSTAL",
            "state": "MN",
            "postal_code": "554283556",
            "telephone_number": "176-353-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRYSTAL DENTAL CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-11",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A",
        "authorized_official_last_name": "MURPHY",
        "authorized_official_first_name": "KIMBERLEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-537-3655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "crystaldental@popp.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "5640 W Broadway Ave",
            "city": "Crystal",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554283556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CRYSTAL DENTAL CARE INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Crystal, MN
• Providers in Crystal, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.