Creekside Family Dental PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

D12567 Issued in MN

Legal business name

CREEKSIDE FAMILY DENTAL PLLC

Practice address

Giebenhain Dental Associates, P.a.
5851 Duluth Street # 103
Golden Valley, MN 55422

Phone

(763) 545-0330

Fax

(763) 277-2096

NPI assigned

Jul 12, 2018

Last updated

Jul 12, 2018By 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

Michael E Giebenhain, DDS

Title

Owner

Phone

(763) 545-0330

Specialties & licenses 1

Addresses

Other names 1

• Giebenhain Dental Associates, P.A. Other name

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.

• John Nicholas Giebenhain Jr., D.D.S.

  • General Practice Dentistry
  • Golden Valley, MN
  • NPI 1619142197
  NPD (past)

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1366928426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "GIEBENHAIN DENTAL ASSOCIATES, P.A.",
            "address_2": "5851 DULUTH STREET # 103",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-545-0330",
            "fax_number": "763-277-2096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GIEBENHAIN DENTAL ASSOCIATES, P.A.",
            "address_2": "5851 DULUTH STREET # 103",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "55422",
            "telephone_number": "763-545-0330",
            "fax_number": "763-277-2096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE FAMILY DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "GIEBENHAIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-545-0330",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Giebenhain Dental Associates, P.A.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Dentist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.