Adt Dental, LTD.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ADT DENTAL, LTD.

Practice address

2232 Hennepin Ave
Minneapolis, MN 55405-2737

Phone

(612) 377-6108

Fax

(612) 374-1820

NPI assigned

Jul 25, 2006

Last updated

Aug 22, 2020By 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

Ms. Susan Zecco

Title

Clinic Administrator

Phone

(612) 377-6108

Specialties & licenses 1

Addresses

Other identifiers 4

Practitioners 2

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.

• Adele Della Torre, DDS

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1558383679
  NPD (past)
• Alice M. Ottavi, DDS

  • General Practice Dentistry
  • Minneapolis, MN
  • NPI 1659393783
  NPD (past)

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548282585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052737",
            "telephone_number": "612-377-6108",
            "fax_number": "612-374-1820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554052737",
            "telephone_number": "612-377-6108",
            "fax_number": "612-374-1820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADT DENTAL, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ZECCO",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "612-377-6108",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "46092 DE",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "978483",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL DENTAL",
            "identifier": "013454",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "1727",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.