Basile Orthodontics PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

MN10983 Issued in MN

Legal business name

BASILE ORTHODONTICS PA

Practice address

5116 Gateway Street SE #103
Suite #103
Prior Lake, MN 55372

Phone

(952) 447-6088

Fax

(952) 447-6099

NPI assigned

Feb 20, 2007

Organization subpart

Yes

Parent organization

BASILE ORTHODONTICS PAAs reported in NPPES

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

Authorized official

Name

Dr. Joseph Samuel Basile III, D.D.S.

Title

Orthodontist

Phone

(952) 454-5345

Specialties & licenses 1

Addresses

Other names 1

• Prior Lake Orthodontics Doing business as

Tax ID family

Basile Orthodontics PA2 organizations share this tax ID, including this one

Part of

Basile Orthodontics PA

Other organizations with this tax ID 1

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

• Basile Orthodontics PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Minnetonka, MN
  • NPI 1194939041
  NPD tax ID

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234828800000",
    "number": "1679618326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 GATEWAY ST. S.E.",
            "address_2": "SUITE 103",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "55372",
            "telephone_number": "952-447-6088",
            "fax_number": "952-447-6099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5116 GATEWAY STREET SE #103",
            "address_2": "SUITE #103",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "55372",
            "telephone_number": "952-447-6088",
            "fax_number": "952-447-6099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASILE ORTHODONTICS PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BASILE ORTHODONTICS PA",
        "enumeration_date": "2007-02-20",
        "last_updated": "2009-02-17",
        "status": "A",
        "authorized_official_last_name": "BASILE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "SAMUEL",
        "authorized_official_title_or_position": "ORTHODONTIST",
        "authorized_official_telephone_number": "952-454-5345",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "MN10983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prior Lake Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Belland Family Dentistry PLLC
• Blake Belland, DDS
• Robert L Benton
• Brianna Berg

• Orthodontics and Dentofacial Orthopedics Dentistry in Prior Lake, MN
• Providers in Prior Lake, MN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2009; 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.