NPIMap

Organization Active NPI

Tangletown Dental LLC

  • Dental Clinic/Center
  • Minneapolis, MN
National Provider Identifier
1558776815
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8320 Issued in MN
Legal business name
TANGLETOWN DENTAL LLC
Practice address
4831 Nicollet Ave
Minneapolis, MN 55419-5534
Phone
(612) 822-2324
Fax
(612) 822-6763
NPI assigned
Jun 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Authorized official

Name
Jan A Nielsen
Title
Office Manager
Phone
(612) 822-2324

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 8320 MN Primary

Addresses

Primary practice location

4831 Nicollet Ave
Minneapolis, MN 55419-5534

Mailing address

4831 Nicollet Ave
Minneapolis, MN 55419-5534
Phone (612) 822-2324

National Provider Directory

National Provider Directory

Locations

4831 Nicollet Ave
Minneapolis, MN 55419
Phone (612) 822-2234

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403654400000",
    "number": "1558776815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4831 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195534",
            "telephone_number": "612-822-2324",
            "fax_number": "612-822-6763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4831 NICOLLET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195534",
            "telephone_number": "612-822-2324",
            "fax_number": "612-822-6763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANGLETOWN DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-25",
        "last_updated": "2014-06-25",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "JAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "612-822-2324"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "8320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.