NPIMap

Organization Active NPI

Madison-Nelson Family Dentistry

  • General Practice Dentistry
  • Duluth, MN
National Provider Identifier
1619064557
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D10521 Issued in MN
Legal business name
MADISON-NELSON FAMILY DENTISTRY
Practice address
324 W Superior St Ste 700
Duluth, MN 55802-1721
Phone
(218) 722-7831
NPI assigned
Oct 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gary MadisonNPI 1497843361
Title
Dentist
Phone
(218) 722-7831

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D10521 MN Primary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X D11583 MN

Addresses

Primary practice location

324 W Superior St Ste 700
Duluth, MN 55802-1721

Mailing address

324 W Superior St Ste 700
Duluth, MN 55802-1721
Phone (218) 722-7831

National Provider Directory

National Provider Directory

Locations

324 W Superior St
Ste 700
Duluth, MN 55802
Phone (218) 722-7831

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619064557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 700",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021721",
            "telephone_number": "218-722-7831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 W SUPERIOR ST STE 700",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021721",
            "telephone_number": "218-722-7831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON-NELSON FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MADISON",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "218-722-7831"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D10521",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11583",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • 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.