Active NPI
Oak Park Dental Clinic
- General Practice Dentistry
- Pine City, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- Legal business name
- OAK PARK DENTAL CLINIC
- Practice address
- 505 Johnson Ave SE
Pine City, MN 55063-2108 - Phone
- (320) 629-2282
- Fax
- (320) 629-3357
- NPI assigned
- Mar 11, 2008
- Last updated
- Mar 12, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jon E Cruz, D.D.S.
- Title
- Dentist/Owner
- Phone
- (320) 629-2282
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | Primary |
Addresses
Primary practice location
505 Johnson Ave SE
Pine City, MN 55063-2108
Mailing address
505 Johnson Ave SE
Pine City, MN 55063-2108
Phone (320) 629-2282
National Provider Directory
National Provider Directory- Tax ID family
- Oak Park Dental Clinic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- General Practice Dentistry
- Pine City, MN
- NPI 1720063589
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205193600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205280000000",
"number": "1508036070",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 JOHNSON AVE SE",
"city": "PINE CITY",
"state": "MN",
"postal_code": "550632108",
"telephone_number": "320-629-2282",
"fax_number": "320-629-3357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 JOHNSON AVE SE",
"city": "PINE CITY",
"state": "MN",
"postal_code": "550632108",
"telephone_number": "320-629-2282",
"fax_number": "320-629-3357"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OAK PARK DENTAL CLINIC",
"organizational_subpart": "NO",
"enumeration_date": "2008-03-11",
"last_updated": "2008-03-12",
"status": "A",
"authorized_official_last_name": "CRUZ",
"authorized_official_first_name": "JON",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "DENTIST/OWNER",
"authorized_official_telephone_number": "320-629-2282",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.D.S."
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pine City, MN
- Joseph Norbert Nilsson, DC
- Lisa Elizabeth Nos-Tollefson, PSYD LPCC
- Nu Beginnings Psychological Services, PLLC (Nu Beginnings Psychological Services)
- Tamera Katherine O'Neill, MA, LPCC
- Oak Park Dental - Pine City LLC
- Bruce A Oleary, LMFT
- Lauren Olson, MS, LMFT
- Shannon Marie Olson, CNP
- Karen Lynn Overholser Hovland, RN, PHN
- Samantha Partch, MA, LPCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.