Center Street Dental Professionals, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CENTER STREET DENTAL PROFESSIONALS, P.A.

Practice address

308 Center St W
Roseau, MN 56751-1419

Phone

(218) 463-1070

Fax

(218) 463-1170

NPI assigned

Mar 10, 2008

Organization subpart

No

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

Authorized official

Name

Nghi Trinh-Pham, DDS

Title

President

Phone

(218) 463-1070

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Nghi Trinh-Pham, DDS Other name

Locations

Practitioners 1

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

• Philip Bruce Sallberg, DDS

  • Dentist
  • Roseau, MN
  • NPI 1992786966
  NPD (past)

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

{
    "created_epoch": "1205107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658448000000",
    "number": "1346410909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 CENTER ST W",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511419",
            "telephone_number": "218-463-1070",
            "fax_number": "218-463-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 CENTER ST W",
            "city": "ROSEAU",
            "state": "MN",
            "postal_code": "567511419",
            "telephone_number": "218-463-1070",
            "fax_number": "218-463-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER STREET DENTAL PROFESSIONALS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-10",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A",
        "authorized_official_last_name": "TRINH-PHAM",
        "authorized_official_first_name": "NGHI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "218-463-1070",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "8357",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEE FOR SERVICE PROVIDER",
            "identifier": "1346410909",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nghi Trinh-Pham, DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sarah Blakeslee, MOTR/L
• David A Brett, D.O.
• Sara B Broten, PHARMD
• Vangievail Jean Byfuglien
• Janice G Carr-Herseth, LICSW
• Kayla Dahl
• Shivali Devgon, MD
• Annabi I Djalo, MD
• Cynthia Faye Drost-Sandy, DDS
• Tara Ellenson, MOTR/L

• General Practice Dentistry in Roseau, MN
• Providers in Roseau, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; 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.