NPIMap

Organization Active NPI

Dentalign, PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Lakeville, MN
National Provider Identifier
1386489318
Registry record updated Jul 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
DENTALIGN, PA
Doing business as
TC Orthodontics
Practice address
10920 175TH Court W
Lakeville, MN 55044
Phone
(952) 892-5300
Fax
(763) 420-5510
NPI assigned
Jul 1, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2024

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

Authorized official

Name
Chad H Kelly, DMD
Title
President
Phone
(763) 420-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

10920 175TH Court W
Lakeville, MN 55044

Mailing address

4630 Edgebrook Place
Edina, MN 55424
Phone (763) 420-1030

Other names 1

  • TC Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dentalign PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

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": "1719792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719792000000",
    "number": "1386489318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 EDGEBROOK PLACE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55424",
            "telephone_number": "763-420-1030",
            "fax_number": "763-420-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10920 175TH COURT W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "55044",
            "telephone_number": "952-892-5300",
            "fax_number": "763-420-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTALIGN, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-01",
        "last_updated": "2024-07-01",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-420-1030",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TC Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.