NPIMap

Organization Active NPI

Pine Lakes Endodontics PA

  • Endodontics
  • Baxter, MN
National Provider Identifier
1386305779
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
Legal business name
PINE LAKES ENDODONTICS PA
Practice address
13046 Falcon Dr Ste 2
Baxter, MN 56425-4201
Phone
(217) 520-2397
NPI assigned
Jan 6, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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

Authorized official

Name
Dr. Brock Aaron Droll, DMD, MSNPI 1205164704
Title
Endodontist
Phone
(217) 520-2397

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 Primary

Addresses

Primary practice location

13046 Falcon Dr Ste 2
Baxter, MN 56425-4201

Mailing address

13046 Falcon Dr Ste 2
Baxter, MN 56425-4201

National Provider Directory

National Provider Directory

Locations

13046 Falcon Dr
#2
Baxter, MN 56425
Phone (217) 520-2397

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": "1641427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641427200000",
    "number": "1386305779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13046 FALCON DR STE 2",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564254201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13046 FALCON DR STE 2",
            "city": "BAXTER",
            "state": "MN",
            "postal_code": "564254201",
            "telephone_number": "217-520-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE LAKES ENDODONTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A",
        "authorized_official_last_name": "DROLL",
        "authorized_official_first_name": "BROCK",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "ENDODONTIST",
        "authorized_official_telephone_number": "217-520-2397",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baxter, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.