Northdale Dentist PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12003 Issued in MN

Legal business name

NORTHDALE DENTIST PA

Practice address

2147, Northdale Blvd NW.
Coon Rapids, MN 55433

Phone

(763) 497-6977

Fax

(763) 463-7807

NPI assigned

Oct 13, 2010

Last updated

Oct 13, 2010By 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. Jagannatian Ramakrishnan, B.D.S.

Title

Dentist

Phone

(763) 218-2887

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1286928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1619287562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6808, 67TH STREET NE.",
            "city": "ALBERTVILLE",
            "state": "MN",
            "postal_code": "55301",
            "telephone_number": "763-218-2887",
            "fax_number": "763-463-7807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2147, NORTHDALE BLVD NW.",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55433",
            "telephone_number": "763-497-6977",
            "fax_number": "763-463-7807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHDALE DENTIST PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-13",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "RAMAKRISHNAN",
        "authorized_official_first_name": "JAGANNATIAN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "763-218-2887",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "B.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Suburban Counseling Center
• North Suburban Counseling Ctr
• North Suburban Eye Specialists, LLP
• North Suburban Optical (Optical Studios)
• North Suburban Urology of Coon Rapids, Inc.
• Northern OB GYN Associates PC (Northern Ob/Gyn Associates)
• Northern Pines Counseling Center, Inc.
• Northland Dental Partners, PLLC (Cedar Bend Dental Care)
• Northland Hearing Centers, Inc. (Sound Point Audiology)
• Amanda Elizabeth Northrup, NP

• General Practice Dentistry in Coon Rapids, MN
• Providers in Coon Rapids, 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 Oct 13, 2010; 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.