Cedar Island Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CEDAR ISLAND DENTAL

Practice address

7378 Kirkwood CT N
Maple Grove, MN 55369-5270

Phone

(763) 391-7600

NPI assigned

Sep 12, 2011

Organization subpart

No

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

Authorized official

Name

Genie Kuble

Title

Contact Officer

Phone

(920) 450-0157

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1315785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315785600000",
    "number": "1619259181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7378 KIRKWOOD CT N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7378 KIRKWOOD CT N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695270",
            "telephone_number": "763-391-7600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR ISLAND DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-12",
        "last_updated": "2011-09-12",
        "status": "A",
        "authorized_official_last_name": "KUBLE",
        "authorized_official_first_name": "GENIE",
        "authorized_official_title_or_position": "CONTACT OFFICER",
        "authorized_official_telephone_number": "920-450-0157"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alicia K. Cassel
• Cynthia C Cassel, PA-C
• Cats Candor Therapy PA
• Jill Marie Cazett, MAOTR/L
• CBD Homecare, Inc.
• Kyle R Cedermark, MD
• Lily J Cerar
• Katherine Tingting Chang, MD
• Sung E Chang, D.D.S.
• Chart Your Course Therapeutic Services

• General Practice Dentistry in Maple Grove, MN
• Providers in Maple Grove, 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 Sep 12, 2011; 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.