Main Street Dental MC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2865172 Issued in MN

Legal business name

MAIN STREET DENTAL MC

Practice address

405 E Main Street
Blooming Prairie, MN 55917

Phone

(507) 583-2141

Fax

(507) 583-7574

NPI assigned

Feb 14, 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

John M Flor, DDSNPI 1467432021

Title

Chief Financial Officer

Phone

(507) 583-2141

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.

• John Michael Flor

  • General Practice Dentistry
  • Blooming Prairie, MN
  • NPI 1467432021
  Authorized official Same address or phone

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649244914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 E MAIN STREET",
            "city": "BLOOMING PRAIRIE",
            "state": "MN",
            "postal_code": "55917",
            "telephone_number": "507-583-2141",
            "fax_number": "507-583-7574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 E MAIN STREET",
            "city": "BLOOMING PRAIRIE",
            "state": "MN",
            "postal_code": "55917",
            "telephone_number": "507-583-2141",
            "fax_number": "507-583-7574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET DENTAL MC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FLOR",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "507-583-2141",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "2865172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deloris Harber
• Brooke Hoebing
• Johnson Bros. Golf Cars Inc.
• Deborah Jean Lien, DDS, MBS
• Main Street Dental Clinic of Blooming Prairie, PLLP
• Prairie Family & Sports Chiropractic PA
• Prairie Manor Inc. (Heather Haus)
• Luke John Rennie Jr.
• Daniel Michael Schafer, DDS
• Jeffrey Allen Schwert, DDS

• General Practice Dentistry in Blooming Prairie, MN
• Providers in Blooming Prairie, 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 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.