NPIMap

Organization Active NPI

Luke Waln Dentistry, PC

Doing business as Nisswa Smiles

  • Dentist
  • Nisswa, MN
National Provider Identifier
1427680040
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
LUKE WALN DENTISTRY, PC
Doing business as
Nisswa Smiles
Practice address
25477 Main St
Nisswa, MN 56468-5001
Phone
(218) 963-6330
Fax
(218) 963-6332
NPI assigned
Feb 11, 2020
Last updated
Jan 27, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Luke E Waln, DDSNPI 1740263094
Title
Owner/Dentist
Phone
(218) 963-6330

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
Dentist 122300000X NU Primary

Addresses

Primary practice location

25477 Main St
Nisswa, MN 56468-5001

Mailing address

PO Box 454
Nisswa, MN 56468-0454
Phone (218) 963-6330

Other names 1

  • Nisswa Smiles Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address frontdesk@nisswasmiles.com

National Provider Directory

National Provider Directory

Locations

25477 Main St
Nisswa, MN 56468
Phone (218) 963-6330

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1581379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1427680040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 454",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564680454",
            "telephone_number": "218-963-6330",
            "fax_number": "218-963-6332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25477 MAIN ST",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564685001",
            "telephone_number": "218-963-6330",
            "fax_number": "218-963-6332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUKE WALN DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-11",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "WALN",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "218-963-6330",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "frontdesk@nisswasmiles.com",
            "affiliation": "N",
            "address_1": "25477 Main St",
            "city": "Nisswa",
            "state": "MN",
            "country_code": "US",
            "postal_code": "564685001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Nisswa Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nisswa, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.