Mdo Periodontics PA

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

MDO PERIODONTICS PA

Practice address

1900 Kruchten CT S
Ste. 101
Sartell, MN 56377-4730

Phone

(320) 240-9028

Fax

(320) 240-9048

NPI assigned

Nov 20, 2008

Last updated

Nov 20, 2008By 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

Michelle Grundhoefer

Title

Office Manager

Phone

(320) 240-9028

Specialties & licenses 1

Addresses

Locations

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.

• Marc Dana Orjansen, DDS, MS

  • Periodontics
  • Saint Cloud, MN
  • NPI 1194813808
  NPD (past)

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1558516369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 KRUCHTEN CT S",
            "address_2": "STE. 101",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774730",
            "telephone_number": "320-240-9028",
            "fax_number": "320-240-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 KRUCHTEN CT S",
            "address_2": "STE. 101",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774730",
            "telephone_number": "320-240-9028",
            "fax_number": "320-240-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDO PERIODONTICS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "GRUNDHOEFER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "320-240-9028"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Sartell, MN
• Providers in Sartell, MN by specialty
• Periodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 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.

Verify at the official NPI Registry.