NPIMap

Organization Active NPI

Waynewood & Associates, P.a.

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1366681082
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D8084 Issued in MN
Legal business name
WAYNEWOOD & ASSOCIATES, P.A.
Doing business as
KingField Family Dental
Practice address
17 E 38TH St
Minneapolis, MN 55409-1341
Phone
(612) 353-5443
Fax
(612) 353-5440
NPI assigned
Feb 19, 2009
Organization subpart
Yes
Parent organization
WAYNEWOOD & ASSOCIATES, P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Authorized official

Name
Nesret Shu-Ankh
Title
Practice Manager
Phone
(651) 647-9697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D8084 MN Primary

Addresses

Primary practice location

17 E 38TH St
Minneapolis, MN 55409-1341

Mailing address

393 Dunlap St N
Suite 650
Saint Paul, MN 55104-4200
Phone (651) 647-9697

Other names 1

  • KingField Family Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Waynewood Associates PA2 organizations share this tax ID, including this one
Part of
Waynewood Associates PA

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

393 Dunlap St N
Ste 650
Saint Paul, MN 55104
Phone (651) 647-9697

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

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": "1235001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235001600000",
    "number": "1366681082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "393 DUNLAP ST N",
            "address_2": "SUITE 650",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044200",
            "telephone_number": "651-647-9697",
            "fax_number": "651-646-2771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 E 38TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091341",
            "telephone_number": "612-353-5443",
            "fax_number": "612-353-5440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNEWOOD & ASSOCIATES, P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNEWOOD & ASSOCIATES, P.A.",
        "enumeration_date": "2009-02-19",
        "last_updated": "2009-02-19",
        "status": "A",
        "authorized_official_last_name": "SHU-ANKH",
        "authorized_official_first_name": "NESRET",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "651-647-9697"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D8084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KingField Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.