Carver Dental PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D12924 Issued in MN

Legal business name

CARVER DENTAL PA

Practice address

4725 Dahlgren Rd
Carver, MN 55315-2201

Phone

(952) 960-9060

Fax

(952) 960-9066

NPI assigned

Feb 27, 2017

Last updated

Feb 27, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Adam HolderNPI 1609169762

Title

Owner/Dentist

Phone

(218) 839-0873

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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.

• Adam Michael Holder, D.D.S.

  • Dentist
  • Hinckley, MN
  • NPI 1609169762
  NPD (past) Authorized official
• Dale Richard Brown, DDS

  • Dentist
  • Carver, MN
  • NPI 1104495225
  NPD (past)
• Michael Hammon, DMD

  • General Practice Dentistry
  • St Louis Park, MN
  • NPI 1417410556
  NPD (past)

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1528508348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4725 DAHLGREN RD",
            "city": "CARVER",
            "state": "MN",
            "postal_code": "553152201",
            "telephone_number": "952-960-9060",
            "fax_number": "952-960-9066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4725 DAHLGREN RD",
            "city": "CARVER",
            "state": "MN",
            "postal_code": "553152201",
            "telephone_number": "952-960-9060",
            "fax_number": "952-960-9066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARVER DENTAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "HOLDER",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "218-839-0873"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D12924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aegis Group Practice LLC
• Dale Richard Brown, DDS
• Jacquelyn Ann Christianson
• Danica Holscher, Nurse Practitioner Medical Aesthetics (The Rural Aesthetic Med Spa)
• Lauren Rochelle Eich, MS, RD, LD, CLC
• Ann Frey, R.D
• Kerry Gilbert, LAC

• Dental Clinic/Center in Carver, MN
• Providers in Carver, 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 Feb 27, 2017; 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.