Plymouth Plaza Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8320 Issued in MN

Legal business name

PLYMOUTH PLAZA DENTAL

Practice address

1495 County Road 101 N
Suite2
Plymouth, MN 55447-3078

Phone

(763) 476-6774

Fax

(763) 476-2147

NPI assigned

Apr 24, 2007

Organization subpart

No

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

Authorized official

Name

Janet Ann Nielsen

Title

Office Manager

Phone

(763) 476-6774

Specialties & licenses 1

Addresses

Practitioners 1

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

• Paul D Boettner, D.D.S.

  • General Practice Dentistry
  • Plymouth, MN
  • NPI 1831380716
  NPD (past)

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609095140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 COUNTY ROAD 101 N",
            "address_2": "SUITE2",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554473078",
            "telephone_number": "763-476-6774",
            "fax_number": "763-476-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 COUNTY ROAD 101 N",
            "address_2": "SUITE2",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554473078",
            "telephone_number": "763-476-6774",
            "fax_number": "763-476-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLYMOUTH PLAZA DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "NIELSEN",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "763-476-6774"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "8320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Plymouth Chirocenter LLC
• Plymouth Dental Care PC
• Plymouth Family Dentistry, LLC
• Plymouth Grove Chiropractic, P.a.
• Plymouth Orthopedic Surgery Center LLC
• Plymouth Psych Group, LLC
• Plymouth Senior Housing, LLC
• Plymouth Smiles Dentistry, PC
• Plymouth Station Dental, PA
• Plymouth Vision Center, Inc.

• General Practice Dentistry in Plymouth, MN
• Providers in Plymouth, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.