M Dental PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

M DENTAL PLLC

Doing business as

North Shore Dental Ltd

Practice address

4707 E Superior St
Duluth, MN 55804-2339

Phone

(207) 332-0028

NPI assigned

Sep 9, 2019

Organization subpart

No

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

Authorized official

Name

Trevor J McCollough, DMDNPI 1598285454

Title

Dentist

Phone

(207) 332-0028

Specialties & licenses 1

Addresses

Other names 1

• North Shore Dental Ltd Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Trevor McCollough, DMD

  • General Practice Dentistry
  • Duluth, MN
  • NPI 1598285454
  NPD Authorized official

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

{
    "created_epoch": "1567987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567987200000",
    "number": "1609425032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042043",
            "telephone_number": "207-332-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042339",
            "telephone_number": "207-332-0028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Waterfront Dr",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161525",
            "country_code": "US",
            "telephone_number": "207-332-0028",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "M DENTAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-09",
        "last_updated": "2019-09-09",
        "status": "A",
        "authorized_official_last_name": "MCCOLLOUGH",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "207-332-0028",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Dental Ltd",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark Lewis Lykins, APRN/CNP
• Robert Floyd Lyman, MSED
• Serena Lynch, CPM, LM
• Daniel Stephan Lyon, DO
• Jeffrey Edmund Lyon
• Danielle Amber Macdonald, PHARMACIST
• Deborah Ann Macdonald, APRN, CNS
• Crystal Marie Macfarlane, RN
• Jordan Wolfgang Mach
• Katelyn Maciej, MA, LADC, LPCC

• Dental Clinic/Center in Duluth, MN
• Providers in Duluth, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2019; 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.