Albert Lee Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

ALBERT LEE INC.

Doing business as

Granite City Family and Cosmetic Dentistry

Practice address

429 Great Oak Dr
Waite Park, MN 56387-2507

Phone

(320) 774-3610

NPI assigned

Mar 14, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Kari L Peterson, DDS

Title

Owner

Phone

(320) 774-3610

Specialties & licenses 1

Addresses

Other names 1

• Granite City Family and Cosmetic Dentistry Doing business as

Locations

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

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647216000000",
    "number": "1750039327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "429 GREAT OAK DR",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563872507",
            "telephone_number": "320-774-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 GREAT OAK DR",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563872507",
            "telephone_number": "320-774-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALBERT LEE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "KARI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "320-774-3610",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granite City Family and Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zeinab Ahmed
• Rayan Aided
• Rachel Ann Ainali
• Olugbemi Dickson Akinlosotu
• Hakeem Alabi
• Asiya Kamaan Ali
• Ayan Ahmed Ali
• Faiza Ali
• Habsa Ali
• Hodan Jama Ali

• Dental Clinic/Center in Waite Park, MN
• Providers in Waite Park, 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 14, 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.