Patrick J Ennen DDS PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

7668 Issued in MN

Legal business name

PATRICK J ENNEN DDS PA

Practice address

3960 Coon Rapids Blvd NW
213
Coon Rapids, MN 55433-2569

Phone

(763) 427-4912

NPI assigned

Jan 20, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Patrick Joseph Ennen, DDSNPI 1710944988

Title

President

Phone

(763) 427-4912

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Patrick Joseph Ennen, DDS

  • Periodontics
  • Coon Rapids, MN
  • NPI 1710944988
  Authorized official Same address or phone

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346393485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3960 COON RAPIDS BLVD NW",
            "address_2": "213",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332569",
            "telephone_number": "763-427-4912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3960 COON RAPIDS BLVD NW",
            "address_2": "213",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332569",
            "telephone_number": "763-427-4912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK J ENNEN DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ENNEN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-427-4912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "7668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manpreet Kaur Parmar, M.D.
• Kamrie Ann Parrott, FNP-C
• Zoya E Parsi
• John C. Pastorius, MD
• Induruwa Nelani Pathirana, M.D.
• Alison C. Paulsen
• Christine Paulson
• Linda Paulson
• Ariel Pavelka, MA, LMFT
• Lorenzo Angelo Pavoloni, PA-C

• Dental Clinic/Center in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Dental Clinic/Center 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.