Minnetonka Dental Partners LLC

Primary specialty

DentistTaxonomy code 122300000X

License

D12012 Issued in MN

Legal business name

MINNETONKA DENTAL PARTNERS LLC

Practice address

17909 Delton Ave
Minnetonka, MN 55345

Phone

(952) 474-7057

Fax

(952) 401-1698

NPI assigned

Aug 15, 2014

Organization subpart

No

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

Authorized official

Name

George Rizkalla, DDS

Title

Owner

Phone

(952) 474-7057

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408060800000",
    "number": "1447659495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17909 DELTON AVE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-474-7057",
            "fax_number": "952-401-1698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17909 DELTON AVE",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55345",
            "telephone_number": "952-474-7057",
            "fax_number": "952-401-1698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNETONKA DENTAL PARTNERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-15",
        "last_updated": "2014-08-15",
        "status": "A",
        "authorized_official_last_name": "RIZKALLA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "952-474-7057",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Minnesota Functional Neurology and Chiropractic, LLC (The Functional Neurology Center)
• Minnetonka Ambulatory Surgery Center LLC
• Minnetonka Assisted Living and Hospice
• Minnetonka Care Residence (parkinsons specialty care)
• Minnetonka Counseling LLC
• Minnetonka Dental, P.L.L.C
• Minnetonka Family Chiropractic LLC
• Minnetonka Public Schools
• Minnetonka Senior Living Care, LLC
• Minnetonka Vision Associates PLLC

• Dentist in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2014; 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.