NPIMap

Organization Active NPI

Dentalign P.a.

Doing business as TC Orthodontics

  • Dental Clinic/Center
  • Apple Valley, MN
National Provider Identifier
1639687189
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
11493 Issued in MN
Legal business name
DENTALIGN P.A.
Doing business as
TC Orthodontics
Practice address
15875 Emperor Avenue
Apple Valley, MN 55124
Phone
(651) 344-8817
NPI assigned
Jan 18, 2018
Last updated
Jan 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Authorized official

Name
Chad Holly Kelly, DMD
Title
President/Owner
Phone
(763) 420-1030

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 11493 MN Primary

Addresses

Primary practice location

15875 Emperor Avenue
Apple Valley, MN 55124

Mailing address

4630 Edgebrook Place
Edina, MN 55424
Phone (763) 420-1030

Other names 1

  • TC Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dentalign PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15875 Emperor Ave
Apple Valley, MN 55124
Phone (651) 344-8817

NPI Registry JSON

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1639687189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4630 EDGEBROOK PLACE",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55424",
            "telephone_number": "763-420-1030",
            "fax_number": "763-420-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15875 EMPEROR AVENUE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "55124",
            "telephone_number": "651-344-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTALIGN P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "HOLLY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "763-420-1030",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "11493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TC Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Apple Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; 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.