NPIMap

Organization Active NPI

Orthodontic Care Group

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Prior Lake, MN
National Provider Identifier
1497879951
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTIC CARE GROUP
Practice address
4670 Park Nicollet Ave SE
Prior Lake, MN 55372-3908
Phone
(952) 432-4941
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Karie T Graden
Title
Director of Operations
Phone
(952) 432-1103

Specialties & licenses 1

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

Addresses

Primary practice location

4670 Park Nicollet Ave SE
Prior Lake, MN 55372-3908

Mailing address

14605 Glazier Ave
Apple Valley, MN 55124-7545

Other names 1

  • Orthodontic Care Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Care Group20 organizations share this tax ID, including this one

Other organizations with this tax ID 19

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

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1497879951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14605 GLAZIER AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4670 PARK NICOLLET AVE SE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553723908",
            "telephone_number": "952-432-4941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTIC CARE GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GRADEN",
        "authorized_official_first_name": "KARIE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "952-432-1103"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthodontic Care Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prior Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.