Amber Lea Pearson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12136 Issued in MN

Practice address

9600 Upland LN N Ste 200
Maple Grove, MN 55369-4496

Phone

(763) 416-0037

NPI assigned

Dec 8, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• PDG, P.a.

  dba Park Dental

  • General Practice Dentistry
  • Maple Grove, MN
  • NPI 1487712915
  NPD (past)

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386704757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2053 UPPER SAINT DENNIS RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162810",
            "telephone_number": "712-260-5453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 UPLAND LN N STE 200",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694496",
            "telephone_number": "763-416-0037"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8559 Edinbrook Pkwy",
            "address_purpose": "LOCATION",
            "city": "Brooklyn Park",
            "state": "MN",
            "postal_code": "554433747",
            "country_code": "US",
            "telephone_number": "763-425-3644",
            "fax_number": "763-425-0953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEARSON",
        "first_name": "AMBER",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "747650700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyndsi Jordan Tufte Paumen, MD
• Becky A Paurus
• Melissa Pavlik, LMFT
• PDB, DDS, PA
• PDG, P.a. (Park Dental)
• Maisa Alves Pebbles, CNP
• Joan D. Pechauer, LMFT
• Sara Pederson, MA OTR/L
• Jennifer Ann Pelkey, OTR/L
• Michelle K. Pemble-Frazey, PHD

• General Practice Dentistry in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.