Maplewood Dental Associates PA

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

MAPLEWOOD DENTAL ASSOCIATES PA

Practice address

1736 East Cope Ave
Maplewood, MN 55109-2610

Phone

(651) 770-3831

Fax

(651) 770-9645

NPI assigned

Oct 10, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Richard J Prokosch, DDSNPI 1831286137

Title

President

Phone

(651) 770-6900

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, and the practitioner matching its NPPES authorized official.

• Richard Joseph Prokosch

  • Dentist
  • Maplewood, MN
  • NPI 1831286137
  Authorized official Same address or phone

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": "1619065539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 EAST COPE AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092610",
            "telephone_number": "651-770-3831",
            "fax_number": "651-770-9645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1736 EAST COPE AVE",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551092610",
            "telephone_number": "651-770-3831",
            "fax_number": "651-770-9645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLEWOOD DENTAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PROKOSCH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-770-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maplewood Assisted Living Inc
• Maplewood Assisted Living LLC
• Maplewood Care Group LLC (Elk Ridge Alzheimer's Special Care Center)
• Maplewood Care Residence (parkinsons specialty care)
• Maplewood Chiropractic Health Center PA
• Maplewood Imaging Center LLC
• Maplewood Pediatric Dentistry PLLC
• Maplewood Podiatry
• Maplewood Podiatry Clinic, PA (Midwest Foot & Ankle Specialists, LLC)
• Maplewood Podiatry, LLC

• Dentist in Maplewood, MN
• Providers in Maplewood, MN by specialty
• Dentist 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.