NPIMap

Organization Active NPI

Derek Abramowski DDS

Doing business as Southside Dental Center

  • Dental Clinic/Center
  • Monticello, MN
National Provider Identifier
1538533989
Registry record updated Nov 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D13279 Issued in MN
Legal business name
DEREK ABRAMOWSKI DDS
Doing business as
Southside Dental Center
Practice address
201 Sandberg Rd
Monticello, MN 55362-8906
Phone
(763) 295-5400
Fax
(763) 295-1785
NPI assigned
Nov 23, 2015
Last updated
Nov 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2015

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

Authorized official

Name
Dr. Derek Daniel Abramowski, D.D.S.NPI 1952741290
Title
Owner
Phone
(763) 229-2613

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 D13279 MN Primary

Addresses

Primary practice location

201 Sandberg Rd
Monticello, MN 55362-8906

Mailing address

201 Sandberg Rd
Monticello, MN 55362-8906
Phone (763) 295-5400

Other names 1

  • Southside Dental Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1448236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448236800000",
    "number": "1538533989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SANDBERG RD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628906",
            "telephone_number": "763-295-5400",
            "fax_number": "763-295-1785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SANDBERG RD",
            "city": "MONTICELLO",
            "state": "MN",
            "postal_code": "553628906",
            "telephone_number": "763-295-5400",
            "fax_number": "763-295-1785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK ABRAMOWSKI DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-23",
        "last_updated": "2015-11-23",
        "status": "A",
        "authorized_official_last_name": "ABRAMOWSKI",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "763-229-2613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D13279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; 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.