Mendota Heights Dental Center

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

9102 Issued in MN

Legal business name

MENDOTA HEIGHTS DENTAL CENTER

Practice address

880 Sibley Memorial Hwy
Mendota Heights, MN 55118-1736

Phone

(651) 455-4223

Fax

(651) 455-0107

NPI assigned

Mar 25, 2008

Organization subpart

No

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

Authorized official

Name

Pam J Maxa

Title

Office Manager

Phone

(651) 455-4223

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1730351214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 SIBLEY MEMORIAL HWY",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551181736",
            "telephone_number": "651-455-4223",
            "fax_number": "651-455-0107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 SIBLEY MEMORIAL HWY",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551181736",
            "telephone_number": "651-455-4223",
            "fax_number": "651-455-0107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENDOTA HEIGHTS DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "MAXA",
        "authorized_official_first_name": "PAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-455-4223"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "9102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brock Melander
• Dominique Eva Menard, OTD
• Mendakota Chiropractic, PLLC
• Mendota Autism Center LLC
• Mendota Dental Associates
• Mendota Heights WP LLC
• Mendota Physical Therapy LLC
• Amanda Marie Mesenbrink
• Aubrey Miller, LPCC
• Gregory Aaron Miller

• Dental Clinic/Center in Mendota Heights, MN
• Providers in Mendota Heights, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.