NPIMap

Organization Active NPI

Northland Dental Partners, PLLC

Doing business as Metro Dentalcare St. Paul Midway

  • General Practice Dentistry
  • Saint Paul, MN
National Provider Identifier
1730837105
Registry record updated Mar 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTHLAND DENTAL PARTNERS, PLLC
Doing business as
Metro Dentalcare St. Paul Midway
Practice address
1375 Saint Anthony Ave
Saint Paul, MN 55104-4006
Phone
(651) 645-4671
Fax
(651) 646-1342
NPI assigned
Mar 15, 2022
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHLAND DENTAL PARTNERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

1375 Saint Anthony Ave
Saint Paul, MN 55104-4006

Mailing address

1375 Saint Anthony Ave
Saint Paul, MN 55104-4006
Phone (651) 645-4671

Other names 1

  • Metro Dentalcare St. Paul Midway Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northland Dental Partners43 organizations share this tax ID, including this one
Part of
Northland Dental Partners

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1647302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1730837105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1375 SAINT ANTHONY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044006",
            "telephone_number": "651-645-4671",
            "fax_number": "651-646-1342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1375 SAINT ANTHONY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551044006",
            "telephone_number": "651-645-4671",
            "fax_number": "651-646-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "enumeration_date": "2022-03-15",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dentalcare St. Paul Midway",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2022; 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.