Blaine Orthodontics

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

BLAINE ORTHODONTICS

Practice address

10945 Club West Pkwy
Blaine, MN 55449-6253

Phone

(763) 400-8992

NPI assigned

Dec 29, 2021

Last updated

Dec 29, 2021By 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

Tamara SmithNPI 1376821157

Title

Orthodontist

Phone

(763) 400-8992

Specialties & licenses 1

Addresses

Tax ID family

Blaine Orthodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• White Bear Lake Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • White Bear Lake, MN
  • NPI 1730782467
  NPD tax ID

Locations

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.

• Tamara Smith, D.D.S., M.S.D

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Andover, MN
  • NPI 1376821157
  NPD Authorized official

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

{
    "created_epoch": "1640736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640736000000",
    "number": "1659031854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10945 CLUB WEST PKWY",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496253",
            "telephone_number": "763-400-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10945 CLUB WEST PKWY",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554496253",
            "telephone_number": "763-400-8992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAINE ORTHODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-29",
        "last_updated": "2021-12-29",
        "certification_date": "2021-12-29",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "763-400-8992"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blaine Health Services LLC
• Blaine Health Services LLC (Blaine Health - PCA Services LLC)
• Blaine Kidds Pediatric Dentistry PLLC
• Blaine Lakes Dental, P.L.L.C.
• Blaine MN Multi Specialty ASC LLC (North Metro Surgery Center)
• Blaine Urgency Center, LLC
• Blaine WP II, LLC
• Blaine WP, LLC
• Don R Blakeslee, DDS
• Blooming Connections Pediatric Therapy LLC

• Dental Clinic/Center in Blaine, MN
• Providers in Blaine, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2021; 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.