NPIMap

Organization Active NPI

Dental Specialists of Minnesota, PLLC

  • Dental Clinic/Center
  • Rosemount, MN
National Provider Identifier
1760013015
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
DENTAL SPECIALISTS OF MINNESOTA, PLLC
Practice address
15015 Cimarron Ave
Rosemount, MN 55068-2771
Phone
(952) 926-2835
NPI assigned
Jan 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Authorized official

Name
Shannon Hesse
Title
Credentialing Specialist
Phone
(651) 746-2815

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
Oral and Maxillofacial Pathology DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0106X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

15015 Cimarron Ave
Rosemount, MN 55068-2771

Mailing address

2200 County Road C W Ste 2210
Roseville, MN 55113-2551
Phone (651) 746-2815

Other names 1

  • The Dental Specialists Rosemount Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dental Specialists of Minnesota PLLC30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

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

View all 29

Locations

15015 Cimarron Ave
Rosemount, MN 55068
Phone (952) 423-2288

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580169600000",
    "number": "1760013015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 COUNTY ROAD C W STE 2210",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551132551",
            "telephone_number": "651-746-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15015 CIMARRON AVE",
            "city": "ROSEMOUNT",
            "state": "MN",
            "postal_code": "550682771",
            "telephone_number": "952-926-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL SPECIALISTS OF MINNESOTA, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A",
        "authorized_official_last_name": "HESSE",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "651-746-2815"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Dental Specialists Rosemount",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Dental Specialists Rosemount",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rosemount, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 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.