NPIMap

Organization Active NPI

Northern Orthodontics

  • Dental Clinic/Center
  • Fridley, MN
National Provider Identifier
1659670362
Registry record updated Mar 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
NORTHERN ORTHODONTICS
Practice address
1109 East Moore Lake Drive
Fridley, MN 55432
Phone
(651) 439-2600
Fax
(651) 439-2211
NPI assigned
Mar 21, 2011
Organization subpart
Yes
Parent organization
ST. CROIX VALLEY DENTAL, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 21, 2011

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

Authorized official

Name
Dr. Doug S Wolff, D.D.S.
Title
Owner
Phone
(651) 439-2600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D111236 MN
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

1109 East Moore Lake Drive
Fridley, MN 55432

Mailing address

1109 East Moore Lake Drive
Fridley, MN 55432
Phone (651) 439-2600

National Provider Directory

National Provider Directory
Tax ID family
Minneapolis-St Paul Periodontics12 organizations share this tax ID, including this one
Part of
Minneapolis-St Paul Periodontics

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1300665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300665600000",
    "number": "1659670362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 EAST MOORE LAKE DRIVE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "55432",
            "telephone_number": "651-439-2600",
            "fax_number": "651-439-2211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 EAST MOORE LAKE DRIVE",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "55432",
            "telephone_number": "651-439-2600",
            "fax_number": "651-439-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN ORTHODONTICS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. CROIX VALLEY DENTAL, PLLC",
        "enumeration_date": "2011-03-21",
        "last_updated": "2011-03-21",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "DOUG",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-439-2600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D111236",
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.