Willow Creek Family Dental

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

12181 Issued in MN

Legal business name

WILLOW CREEK FAMILY DENTAL

Practice address

28 Nathan LN N
Plymouth, MN 55441-6306

Phone

(763) 545-1885

NPI assigned

Jan 16, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Neera Madhok

Title

Dentist

Phone

(763) 545-1885

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1508104191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 NATHAN LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 NATHAN LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554416306",
            "telephone_number": "763-545-1885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-16",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "MADHOK",
        "authorized_official_first_name": "NEERA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "763-545-1885",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "12181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keairra Latrece Williams
• Roshaunta Jacquese Evora Williams, BA AFRICAN AMERICAN
• Susan Ora Williams, MSW, LICSW
• Lindsay Grace Williamson, OTR/L
• Willow Bay Therapy, LLC
• Willow Grove Family Dental
• Sandra Ann Willson, PT
• Alexander Wilson, PA STUDENT
• Anthony John Wilson
• Nalissa Wilson

• Dental Clinic/Center in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.