Periowest, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

S13 Issued in MN

Legal business name

PERIOWEST, LLC

Doing business as

PerioWest

Practice address

7810 Terrey Pine CT
Eden Prairie, MN 55347-1186

Phone

(952) 567-7457

NPI assigned

Mar 28, 2008

Organization subpart

No

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

Authorized official

Name

Andres Roberto Sanchez, DDS, MSNPI 1083639504

Title

President

Phone

(952) 393-3634

Specialties & licenses 2

Addresses

Other names 1

• PerioWest Doing business as

Locations

Practitioners 1

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

• Andres Roberto Sanchez, DDS

  • Periodontics
  • Eden Prairie, MN
  • NPI 1083639504
  NPD Authorized official

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597708800000",
    "number": "1609048743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7810 TERREY PINE CT",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471186",
            "telephone_number": "952-567-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7810 TERREY PINE CT",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553471186",
            "telephone_number": "952-567-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIOWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-28",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_middle_name": "ROBERTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-393-3634",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MN",
            "license": "S13",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PerioWest",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Anthony August Pesola, DDS
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• Periodontics in Eden Prairie, MN
• Providers in Eden Prairie, MN by specialty
• Periodontics in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.