NPIMap

Organization Active NPI

Orthodontics Specialist of Minnesota P.L.L.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Coon Rapids, MN
National Provider Identifier
1700310299
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
ORTHODONTICS SPECIALIST OF MINNESOTA P.L.L.C.
Practice address
3360 Northdale Blvd NW
Coon Rapids, MN 55448
Phone
(651) 746-2815
Fax
(651) 209-6312
NPI assigned
Apr 12, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Authorized official

Name
Dr. John Gulon, DDS
Title
President
Phone
(651) 746-2815

Specialties & licenses 1

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

Addresses

Primary practice location

3360 Northdale Blvd NW
Coon Rapids, MN 55448

Mailing address

2200 County Road C W
#2210
Roseville, MN 55113-2550
Phone (651) 633-0500

Other names 1

  • The Dental Specialist-Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Orthodontic Specialists of Minnesota PLLC13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603843200000",
    "number": "1700310299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 COUNTY ROAD C W",
            "address_2": "#2210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132550",
            "telephone_number": "651-633-0500",
            "fax_number": "651-209-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3360 NORTHDALE BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "55448",
            "telephone_number": "651-746-2815",
            "fax_number": "651-209-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHODONTICS SPECIALIST OF MINNESOTA P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A",
        "authorized_official_last_name": "GULON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-746-2815",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dental Specialist-Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Dental Specialist-Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.