NPIMap

Organization Active NPI

Pediatric Dentistry P.C.

  • Pediatric Dentistry
  • Sartell, MN
National Provider Identifier
1326326356
Registry record updated Jul 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
PEDIATRIC DENTISTRY P.C.
Practice address
151 19TH St S
Sartell, MN 56377-2153
Phone
(320) 229-2222
Fax
(888) 563-2069
NPI assigned
Jul 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2011

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

Authorized official

Name
Dr. Liliana Lucas, D.D.S.
Title
President
Phone
(320) 229-2222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

151 19TH St S
Sartell, MN 56377-2153

Mailing address

151 19TH St S
Sartell, MN 56377-2153
Phone (320) 229-2222

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1311552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311552000000",
    "number": "1326326356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 19TH ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772153",
            "telephone_number": "320-229-2222",
            "fax_number": "888-563-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 19TH ST S",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772153",
            "telephone_number": "320-229-2222",
            "fax_number": "888-563-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-25",
        "last_updated": "2011-07-25",
        "status": "A",
        "authorized_official_last_name": "LUCAS",
        "authorized_official_first_name": "LILIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-229-2222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "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 Jul 25, 2011; 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.