NPIMap

Organization Active NPI

St. Croix Valley Dental, PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Stillwater, MN
National Provider Identifier
1689842841
Registry record updated Feb 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
D10622 Issued in MN
Legal business name
ST. CROIX VALLEY DENTAL, PLLC
Practice address
13961 60TH St N
Stillwater, MN 55082-1053
Phone
(651) 351-7777
Fax
(651) 351-5161
NPI assigned
Feb 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2008

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

Authorized official

Name
Dr. Douglas S Wolff, D.D.S
Title
Owner
Phone
(651) 351-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X D10622 MN Primary

Addresses

Primary practice location

13961 60TH St N
Stillwater, MN 55082-1053

Mailing address

13961 60TH St N
PO Box 270
Stillwater, MN 55082-1053
Phone (651) 351-7777

Other names 1

  • Northern Orthodontics Doing business as

National Provider Directory

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

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": "1202688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202688000000",
    "number": "1689842841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13961 60TH ST N",
            "address_2": "PO BOX 270",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550821053",
            "telephone_number": "651-351-7777",
            "fax_number": "651-351-5161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13961 60TH ST N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550821053",
            "telephone_number": "651-351-7777",
            "fax_number": "651-351-5161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CROIX VALLEY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-11",
        "last_updated": "2008-02-11",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-351-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "D10622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; 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.