Collins Orthodontics, PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

COLLINS ORTHODONTICS, PA

Practice address

2946 Jeremiah LN NW
Rochester, MN 55901-4445

Phone

(507) 258-5400

NPI assigned

Sep 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Grant Conrad Collins, DDS, MSNPI 1811208424

Title

Orthodontist, Owner

Phone

(507) 258-5400

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Grant Conrad Collins, D.D.S., M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Rochester, MN
  • NPI 1811208424
  NPD Authorized official
• Alyssa Marie Domico, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Plymouth, MN
  • NPI 1871162669
  NPD (past)

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1700491545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2946 JEREMIAH LN NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559014445",
            "telephone_number": "507-258-5400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 JEREMIAH LN NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559014445",
            "telephone_number": "507-258-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLINS ORTHODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "GRANT",
        "authorized_official_middle_name": "CONRAD",
        "authorized_official_title_or_position": "ORTHODONTIST, OWNER",
        "authorized_official_telephone_number": "507-258-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "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": []
}

• Anitsira Collado Polanco, M.D.
• Maria L Collazo-Clavell, M.D.
• James E Colletti, MD
• Jeahan R Colletti, MD
• Angela Maria Bookwalter Collie, M.D.
• Bethelhem Hope Collins
• Charles S Collins, MD
• Danielle Collins, MB BCH BAO
• Douglas Collins, M.D.
• Grant Conrad Collins, D.D.S., M.S.

• Orthodontics and Dentofacial Orthopedics Dentistry in Rochester, MN
• Providers in Rochester, 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 Mar 23, 2021; 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.