NPIMap

Organization Active NPI

Distinctive Dental Services, PA

  • Dental Clinic/Center
  • Winsted, MN
National Provider Identifier
1457571952
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DISTINCTIVE DENTAL SERVICES, PA
Practice address
131 Main Ave W
Winsted, MN 55395-7873
Phone
(320) 485-4344
Fax
(320) 485-4734
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Authorized official

Name
Dr. Michael John Thoennes, DDSNPI 1265460075
Title
Ceo
Phone
(320) 485-4344

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

131 Main Ave W
Winsted, MN 55395-7873

Mailing address

131 Main Avenue West
Box 599
Winsted, MN 55395-0599
Phone (320) 485-4344

National Provider Directory

National Provider Directory
Tax ID family
Distinctive Dental Services PA3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

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": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1457571952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 MAIN AVENUE WEST",
            "address_2": "BOX 599",
            "city": "WINSTED",
            "state": "MN",
            "postal_code": "553950599",
            "telephone_number": "320-485-4344",
            "fax_number": "320-485-4734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MAIN AVE W",
            "city": "WINSTED",
            "state": "MN",
            "postal_code": "553957873",
            "telephone_number": "320-485-4344",
            "fax_number": "320-485-4734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DISTINCTIVE DENTAL SERVICES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "THOENNES",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-485-4344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winsted, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.