NPIMap

Organization Active NPI

Minnesota Dental Professionals, P.C.

  • General Practice Dentistry
  • Saint Michael, MN
National Provider Identifier
1447896733
Registry record updated Nov 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
MINNESOTA DENTAL PROFESSIONALS, P.C.
Practice address
654 Central Ave E
Saint Michael, MN 55376-9632
Phone
(612) 225-2502
NPI assigned
Nov 21, 2019
Organization subpart
Yes
Parent organization
MINNESOTA DENTAL PROFESSIONALS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2019

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

Authorized official

Name
Jessica Britt
Title
Credentialing Coordinator
Phone
(217) 540-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

654 Central Ave E
Saint Michael, MN 55376-9632

Mailing address

654 Central Ave E
Saint Michael, MN 55376-9632
Phone (612) 225-2502

Other names 1

  • Town Center Dental Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Minnesota Dental Professionals PC23 organizations share this tax ID, including this one
Part of
Minnesota Dental Professionals PC

Other organizations with this tax ID 22

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

View all 22

Locations

654 Central Ave E
Saint Michael, MN 55376
Phone (612) 225-2502

NPI Registry JSON

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574294400000",
    "number": "1447896733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "654 CENTRAL AVE E",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769632",
            "telephone_number": "612-225-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 CENTRAL AVE E",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769632",
            "telephone_number": "612-225-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINNESOTA DENTAL PROFESSIONALS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MINNESOTA DENTAL PROFESSIONALS, P.C.",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A",
        "authorized_official_last_name": "BRITT",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-5100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Town Center Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Michael, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.