Round Lake Family Dentistry, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ROUND LAKE FAMILY DENTISTRY, PLLC

Practice address

13841 Round Lake Blvd NW
Andover, MN 55304-3664

Phone

(763) 427-0285

NPI assigned

Oct 23, 2018

Last updated

Oct 23, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Phillip Zhan, DDS

Title

Owner

Phone

(612) 308-9416

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540252800000",
    "number": "1730655242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7493 147TH ST W STE 100",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247570",
            "telephone_number": "952-432-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13841 ROUND LAKE BLVD NW",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "553043664",
            "telephone_number": "763-427-0285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROUND LAKE FAMILY DENTISTRY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-23",
        "last_updated": "2018-10-23",
        "status": "A",
        "authorized_official_last_name": "ZHAN",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-308-9416",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Ann Robsahm, MT
• Scot Rochon
• Cynthia Roeller, M.A., LMFT
• Christina Mary Rothstein
• Round Lake Dental P.a.
• Julie Ann Rowland, MA, CCC-SLP
• Rtkramer LLC
• Sarah Rudesill, M.A. CCC-SLP
• Charles Ruegemer, PA-C
• Rum River Counseling, Inc.

• Dental Clinic/Center in Andover, MN
• Providers in Andover, 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 Oct 23, 2018; 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.