NPIMap

Organization Active NPI

Vaillant Dental Services, LLC

  • General Practice Dentistry
  • Red Wing, MN
National Provider Identifier
1326243114
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7024 Issued in MN
Legal business name
VAILLANT DENTAL SERVICES, LLC
Practice address
421 W 4TH St
Red Wing, MN 55066-2555
Phone
(651) 388-6709
Fax
(651) 388-3187
NPI assigned
Jun 20, 2007
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
Dr. Dennis Peter Vaillant, DDSNPI 1528063419
Title
Managing Partner
Phone
(651) 388-6709

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 7024 MN Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 11524 MN

Addresses

Primary practice location

421 W 4TH St
Red Wing, MN 55066-2555

Mailing address

421 W 4TH St
Red Wing, MN 55066-2555
Phone (651) 388-6709

Other names 1

  • VAILLANT FAMILY DENTAL Doing business as

National Provider Directory

National Provider Directory

Locations

421 W 4th St
Red Wing, MN 55066
Phone (651) 388-6709

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326243114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 W 4TH ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662555",
            "telephone_number": "651-388-6709",
            "fax_number": "651-388-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 W 4TH ST",
            "city": "RED WING",
            "state": "MN",
            "postal_code": "550662555",
            "telephone_number": "651-388-6709",
            "fax_number": "651-388-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAILLANT DENTAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VAILLANT",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "PETER",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "651-388-6709",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "7024",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "11524",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VAILLANT FAMILY DENTAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Wing, 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.