NPIMap

Organization Active NPI

Lake Superior College Dental Clinic

  • Dental Clinic/Center
  • Duluth, MN
National Provider Identifier
1740400985
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
LAKE SUPERIOR COLLEGE DENTAL CLINIC
Practice address
2101 Trinity Road
Duluth, MN 55811-3349
Phone
(218) 733-5939
Fax
(218) 723-4921
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Cindy A Upton
Title
Dental Hygiene Clinic Coordinator
Phone
(218) 733-5939

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X MN Primary

Addresses

Primary practice location

2101 Trinity Road
Duluth, MN 55811-3349

Mailing address

2101 Trinity Road
Duluth, MN 55811-3349
Phone (218) 733-5939

Other names 1

  • Lake Superior Dental Hygiene Lake Superior Community Dental Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
St Cloud State University27 organizations share this tax ID, including this one

Other organizations with this tax ID 26

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

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740400985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 TRINITY ROAD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113349",
            "telephone_number": "218-733-5939",
            "fax_number": "218-723-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 TRINITY ROAD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113349",
            "telephone_number": "218-733-5939",
            "fax_number": "218-723-4921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SUPERIOR COLLEGE DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "UPTON",
        "authorized_official_first_name": "CINDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTAL HYGIENE CLINIC COORDINATOR",
        "authorized_official_telephone_number": "218-733-5939",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Superior Dental Hygiene Lake Superior Community Dental Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.