NPIMap

Organization Active NPI

Boger-Tri Dental, P.L.L.C.

  • Dentist
  • Minnetonka, MN
National Provider Identifier
1336492834
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
BOGER-TRI DENTAL, P.L.L.C.
Doing business as
Minnetonka Dental Care
Practice address
17909 Delton Ave
Minnetonka, MN 55345-4139
Phone
(952) 474-7057
NPI assigned
Oct 22, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Authorized official

Name
Dr. Jessica Tri, DDS
Title
Dentist
Phone
(952) 474-7057

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

17909 Delton Ave
Minnetonka, MN 55345-4139

Mailing address

17909 Highway 7
Minnetonka, MN 55345-4139
Phone (952) 474-7057

Other names 1

  • Minnetonka Dental Care Doing business as

National Provider Directory

National Provider Directory

Locations

17909 Highway 7
Minnetonka, MN 55345
Phone (952) 474-7057

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": "1350864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1336492834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17909 HIGHWAY 7",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454139",
            "telephone_number": "952-474-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17909 DELTON AVE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553454139",
            "telephone_number": "952-474-7057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOGER-TRI DENTAL, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-22",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "TRI",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "952-474-7057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Minnetonka Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.