NPIMap

Organization Active NPI

Amherst H. Wilder Foundation

Doing business as Wilder Senior Dental Clinic

  • Dental Clinic/Center
  • Saint Paul, MN
National Provider Identifier
1407914674
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
AMHERST H. WILDER FOUNDATION
Doing business as
Wilder Senior Dental Clinic
Practice address
516 Humboldt Ave
Saint Paul, MN 55107
Phone
(651) 220-1807
NPI assigned
Dec 4, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Craig Binger
Title
Vice President Administration
Phone
(651) 642-4000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

516 Humboldt Ave
Saint Paul, MN 55107

Mailing address

650 Marshall Ave
Saint Paul, MN 55104-6644

Other names 1

  • Wilder Senior Dental Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Wilder Senior-Optometry22 organizations share this tax ID, including this one

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407914674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 MARSHALL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 HUMBOLDT AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55107",
            "telephone_number": "651-220-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMHERST H. WILDER FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BINGER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "VICE PRESIDENT ADMINISTRATION",
        "authorized_official_telephone_number": "651-642-4000"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilder Senior Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.