NPIMap

Organization Active NPI

Isles Dental Associates P.a

  • General Practice Dentistry
  • Minneapolis, MN
National Provider Identifier
1447416607
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10995 Issued in MI
Legal business name
ISLES DENTAL ASSOCIATES P.A
Practice address
2534 Hennepin Ave
Minneapolis, MN 55405-3548
Phone
(612) 374-4321
Fax
(612) 381-8518
NPI assigned
Aug 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Mrs. Dawn Marie Miller, CDA-RDA
Title
Administrator
Phone
(612) 374-4321

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D10995 MI Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X M11654 MN

Addresses

Primary practice location

2534 Hennepin Ave
Minneapolis, MN 55405-3548

Mailing address

2534 Hennepin Ave
Minneapolis, MN 55405-3548
Phone (612) 374-4321

Other identifiers 2

IdentifierTypeStateIssuer
1780655753OtherMNNPI NUMBER
1669547477OtherMNNPI NUMBER

National Provider Directory

National Provider Directory

Locations

2534 Hennepin Ave
Minneapolis, MN 55405
Phone (612) 374-4321

Practitioners & affiliated clinicians

Practitioners 3

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": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1447416607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2534 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053548",
            "telephone_number": "612-374-4321",
            "fax_number": "612-381-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2534 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554053548",
            "telephone_number": "612-374-4321",
            "fax_number": "612-381-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISLES DENTAL ASSOCIATES P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "612-374-4321",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CDA-RDA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "D10995",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "M11654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1780655753",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1669547477",
            "state": "MN"
        }
    ],
    "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 Aug 6, 2008; 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.