NPIMap

Organization Active NPI

Wayzata Endodontics, P.a.

  • Endodontics
  • Wayzata, MN
National Provider Identifier
1386189272
Registry record updated Dec 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
WAYZATA ENDODONTICS, P.A.
Practice address
101 Lake Street West
Suite 100
Wayzata, MN 55391
Phone
(952) 476-0070
NPI assigned
Dec 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2016

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

Authorized official

Name
Michael TulkkiNPI 1700978624
Title
Endodontist
Phone
(952) 476-0070

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X MN Primary

Addresses

Primary practice location

101 Lake Street West
Suite 100
Wayzata, MN 55391

Mailing address

101 Lake St W
Suite 100
Wayzata, MN 55391-1576
Phone (952) 476-0070

National Provider Directory

National Provider Directory

Locations

101 Lake St W
Ste 100
Wayzata, MN 55391
Phone (952) 473-4241

Practitioners & affiliated clinicians

Practitioners 1

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": "1483056000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483056000000",
    "number": "1386189272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 LAKE ST W",
            "address_2": "SUITE 100",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "553911576",
            "telephone_number": "952-476-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 LAKE STREET WEST",
            "address_2": "SUITE 100",
            "city": "WAYZATA",
            "state": "MN",
            "postal_code": "55391",
            "telephone_number": "952-476-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYZATA ENDODONTICS, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-30",
        "last_updated": "2016-12-30",
        "status": "A",
        "authorized_official_last_name": "TULKKI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "ENDODONTIST",
        "authorized_official_telephone_number": "952-476-0070"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayzata, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.