NPIMap

Organization Active NPI

Childrens Dental Services Inc

  • Public Health Dentistry
  • Minneapolis, MN
National Provider Identifier
1407973605
Registry record updated Dec 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
Legal business name
CHILDRENS DENTAL SERVICES INC
Practice address
636 Broadway St. NE
Minneapolis, MN 55413
Phone
(612) 746-1530
Fax
(612) 746-1531
NPI assigned
Mar 23, 2007
Last updated
Dec 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2013

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

Authorized official

Name
Sarah Wovcha, J.D., M.P.H
Title
Executive Director
Phone
(612) 636-1577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223D0001X Primary

Addresses

Primary practice location

636 Broadway St. NE
Minneapolis, MN 55413

Mailing address

636 Broadway St. NE
Minneapolis, MN 55413
Phone (612) 746-1530

National Provider Directory

National Provider Directory
Tax ID family
Children's Dental Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 56

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386028800000",
    "number": "1407973605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "636 BROADWAY ST. NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55413",
            "telephone_number": "612-746-1530",
            "fax_number": "612-746-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "636 BROADWAY ST. NE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55413",
            "telephone_number": "612-746-1530",
            "fax_number": "612-746-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS DENTAL SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-23",
        "last_updated": "2013-12-03",
        "status": "A",
        "authorized_official_last_name": "WOVCHA",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "612-636-1577",
        "authorized_official_credential": "J.D., M.P.H"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2013; 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.