Glen Lake Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

GLEN LAKE DENTAL

Practice address

14421 Excelsior Blvd
Minnetonka, MN 55345-5821

Phone

(952) 935-5212

Fax

(952) 935-1391

NPI assigned

Jun 14, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Kristy Taran, DDSNPI 1437342821

Title

Dentist

Phone

(952) 935-5212

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.

• Kristy Lynn Taran, D.D.S.

  • General Practice Dentistry
  • Minnetonka, MN
  • NPI 1437342821
  NPD Authorized official

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

{
    "created_epoch": "1718323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718323200000",
    "number": "1376386607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14421 EXCELSIOR BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553455821",
            "telephone_number": "952-935-5212",
            "fax_number": "952-935-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14421 EXCELSIOR BLVD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553455821",
            "telephone_number": "952-935-5212",
            "fax_number": "952-935-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN LAKE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-14",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A",
        "authorized_official_last_name": "TARAN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "952-935-5212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Mary Gish, LICSW
• Mark Gjengdahl, DC
• Donna Glass, MSN, CRNP
• Paul Glatt, PT, DPT
• Deborah Gleeson, CRNP
• Glen Lake Dental Associates, P.a.
• Glen Lake Family Dentistry P.L.L.C.
• Glenview Care
• Mark Glover, LAMFT
• Rachael Glover

• Dental Clinic/Center in Minnetonka, MN
• Providers in Minnetonka, 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 Jun 14, 2024; 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.