NPIMap

Organization Active NPI

St. Anthony Village Dental Care, P.a.

  • Dental Clinic/Center
  • St Anthony, MN
National Provider Identifier
1659660298
Registry record updated Apr 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D10494 Issued in MN
Legal business name
ST. ANTHONY VILLAGE DENTAL CARE, P.A.
Practice address
2525 33Rd Ave NE
St Anthony, MN 55418-1539
Phone
(612) 781-9270
NPI assigned
Apr 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2011

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

Authorized official

Name
Joseph B Osterbauer, D.D.S.NPI 1265605588
Title
President
Phone
(612) 781-9270

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D10494 MN Primary

Addresses

Primary practice location

2525 33Rd Ave NE
St Anthony, MN 55418-1539

Mailing address

2525 33Rd Ave NE
St Anthony, MN 55418-1539
Phone (612) 781-9270

National Provider Directory

National Provider Directory

Locations

2525 33rd Ave NE
St Anthony, MN 55418
Phone (612) 781-9270

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301961600000",
    "number": "1659660298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 33RD AVE NE",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554181539",
            "telephone_number": "612-781-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 33RD AVE NE",
            "city": "ST ANTHONY",
            "state": "MN",
            "postal_code": "554181539",
            "telephone_number": "612-781-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. ANTHONY VILLAGE DENTAL CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-05",
        "last_updated": "2011-04-05",
        "status": "A",
        "authorized_official_last_name": "OSTERBAUER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-781-9270",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D10494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Anthony, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.