Dental Specialist of Minnesota, PLLC

Organization Active NPI Oral and Maxillofacial Surgery (Dentist) · Wayzata, MN

NPI 1568071199 · NPPES record last updated Jul 29, 2020

Key facts

NPI
1568071199
Entity type
Organization (NPI type 2)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
Legal business name
DENTAL SPECIALIST OF MINNESOTA, PLLC
Practice address
18258 Minnetonka Blvd Ste 100
Wayzata, MN 55391-3324
Phone
(952) 926-2761
NPI assigned
Jul 29, 2020
Organization subpart
No

Authorized official

Name
Shannon Hesse
Title
Credentialing Specialist
Phone
(651) 746-2815

Corporate family (same tax ID) 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners 1

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

National Provider Directory

Tax ID family
Dental Specialists of Minnesota PLLC (30 organizations share this tax ID)

Locations

18258 Minnetonka Blvd
Ste 100
Wayzata, MN 55391
Phone (952) 241-5815

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics
Group: 193200000X MULTI-SPECIALTY GROUP
1223E0200X
Pediatric Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223P0221X
Periodontics
Group: 193200000X MULTI-SPECIALTY GROUP
1223P0300X
Prosthodontics
Group: 193200000X MULTI-SPECIALTY GROUP
1223P0700X
Oral and Maxillofacial Surgery (Dentist)
Group: 193200000X MULTI-SPECIALTY GROUP
1223S0112X Yes

Addresses

Primary practice location

18258 Minnetonka Blvd Ste 100
Wayzata, MN 55391-3324

Mailing address

2200 County Road C W Ste 2210
Roseville, MN 55113-2551
Phone (651) 746-2815

Other names

  • The Dental Specialist Deephaven Doing business as

Other providers in Wayzata, MN

All providers in Wayzata, MN · Oral and Maxillofacial Surgery (Dentist) in Minnesota

Sources for this page

Verify at the official NPI Registry.