Eckart Dental Center LLC

Primary specialty

DentistTaxonomy code 122300000X

License

9527 Issued in MN

Legal business name

ECKART DENTAL CENTER LLC

Practice address

300 1St Ave E
Shakopee, MN 55379-1444

Phone

(952) 445-1352

Fax

(952) 445-7221

NPI assigned

Aug 25, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa M. Kreuser

Title

Office Manager

Phone

(952) 445-1352

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326156910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791444",
            "telephone_number": "952-445-1352",
            "fax_number": "952-445-7221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST AVE E",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791444",
            "telephone_number": "952-445-1352",
            "fax_number": "952-445-7221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECKART DENTAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KREUSER",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-445-1352",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "9527",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS #",
            "identifier": "03905EC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "4040598",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Shakopee, MN
• Providers in Shakopee, MN by specialty
• 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.