NPIMap

Organization Active NPI

Don Sealock, O.D., P.a.

Doing business as Glen Lake Optical

  • Eyewear Supplier
  • Minnetonka, MN
National Provider Identifier
1700335247
Registry record updated Feb 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
DON SEALOCK, O.D., P.A.
Doing business as
Glen Lake Optical
Practice address
15450 Highway 7 # 100
Minnetonka, MN 55345-3522
Phone
(952) 933-7107
Fax
(952) 933-2831
NPI assigned
Sep 26, 2016
Last updated
Feb 6, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
DON SEALOCK, O.D., P.A.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 6, 2019

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

Authorized official

Name
Jennie J Sealock
Title
Secr/Treas
Phone
(763) 551-0529

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X NU Primary

Addresses

Primary practice location

15450 Highway 7 # 100
Minnetonka, MN 55345-3522

Mailing address

15450 Highway 7 # 100
Minnetonka, MN 55345-3522
Phone (952) 933-7107

Other names 1

  • Glen Lake Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Four Seasons Eye Care10 organizations share this tax ID, including this one
Part of
Four Seasons Eye Care

Other organizations with this tax ID 9

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1474848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549411200000",
    "number": "1700335247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15450 HIGHWAY 7 # 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453522",
            "telephone_number": "952-933-7107",
            "fax_number": "952-933-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15450 HIGHWAY 7 # 100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553453522",
            "telephone_number": "952-933-7107",
            "fax_number": "952-933-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DON SEALOCK, O.D., P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DON SEALOCK, O.D., P.A.",
        "enumeration_date": "2016-09-26",
        "last_updated": "2019-02-06",
        "status": "A",
        "authorized_official_last_name": "SEALOCK",
        "authorized_official_first_name": "JENNIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SECR/TREAS",
        "authorized_official_telephone_number": "763-551-0529"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Lake Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Glen Lake Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Minnetonka, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; 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.