NPIMap

Organization Active NPI

Smile Orthodontics Stillwater, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Elk River, MN
National Provider Identifier
1457064818
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
SMILE ORTHODONTICS STILLWATER, LLC
Practice address
305 Main St NW
Elk River, MN 55330-1531
Phone
(651) 351-7777
NPI assigned
Dec 30, 2022
Organization subpart
Yes
Parent organization
SMILE ORTHODONTICS STILLWATER, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Authorized official

Name
Douglas Wolff, DDS
Title
Owner/DDS
Phone
(651) 351-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

305 Main St NW
Elk River, MN 55330-1531

Mailing address

1041 Grand Ave # 531
Saint Paul, MN 55105-3002

Other names 1

  • Smile Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Smile Orthodontics Stillwater LLC5 organizations share this tax ID, including this one
Part of
Smile Orthodontics Stillwater LLC

Other organizations with this tax ID 4

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

Locations

305 Main St NW
Elk River, MN 55330

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1672358400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1457064818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 GRAND AVE # 531",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MAIN ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301531",
            "telephone_number": "651-351-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE ORTHODONTICS STILLWATER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMILE ORTHODONTICS STILLWATER, LLC",
        "enumeration_date": "2022-12-30",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "651-351-7777",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smile Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Smile Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; 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.