Individual provider Active NPI

Joshua Padovano, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Anoka, MN
National Provider Identifier
1578187225
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D14336 Issued in MN
Practice address
3507 Round Lake Blvd NW Ste 900
Anoka, MN 55303-4908
Phone
(763) 323-7677
NPI assigned
May 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X D14336 MN Primary

Addresses

Primary practice location

3507 Round Lake Blvd NW Ste 900
Anoka, MN 55303-4908

Mailing address

3507 Round Lake Blvd NW Ste 900
Anoka, MN 55303-4908

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D14336MNMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Orthodontic Specialists PLC Orthodontics and Dentofacial Orthopedics CurrentSince Apr 1, 2022 Accepting new patients

Locations

3507 Round Lake Blvd NW
Ste 900
Anoka, MN 55303
Phone (763) 233-3122

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1578187225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3507 ROUND LAKE BLVD NW STE 900",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 ROUND LAKE BLVD NW STE 900",
            "city": "ANOKA",
            "state": "MN",
            "postal_code": "553034908",
            "telephone_number": "763-323-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADOVANO",
        "first_name": "JOSHUA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-28",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D14336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anoka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 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.