NPIMap

Organization Active NPI

Main Street Dental Clinic of New Richland PLLP

  • General Practice Dentistry
  • New Richland, MN
National Provider Identifier
1316911415
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8069253 Issued in MN
Legal business name
MAIN STREET DENTAL CLINIC OF NEW RICHLAND PLLP
Practice address
132 North Broadway
New Richland, MN 56072
Phone
(507) 463-0502
Fax
(507) 463-0769
NPI assigned
Feb 15, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John M Flor, DDSNPI 1467432021
Title
Chief Financial Officer
Phone
(507) 583-2141

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
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 8069253 MN Primary

Addresses

Primary practice location

132 North Broadway
New Richland, MN 56072

Mailing address

132 North Broadway
PO Box 278
New Richland, MN 56072
Phone (507) 463-0502

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1139961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316911415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 NORTH BROADWAY",
            "address_2": "PO BOX 278",
            "city": "NEW RICHLAND",
            "state": "MN",
            "postal_code": "56072",
            "telephone_number": "507-463-0502",
            "fax_number": "507-463-0769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 NORTH BROADWAY",
            "city": "NEW RICHLAND",
            "state": "MN",
            "postal_code": "56072",
            "telephone_number": "507-463-0502",
            "fax_number": "507-463-0769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTAL CLINIC OF NEW RICHLAND PLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLOR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "507-583-2141",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8069253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Richland, MN

Sources for this page

  • 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.