NPIMap

Organization Active NPI

Al Shifa Dentistry PA

  • Dental Clinic/Center
  • Maple Grove, MN
National Provider Identifier
1760703151
Registry record updated Jun 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
D12215 Issued in MN
Legal business name
AL SHIFA DENTISTRY PA
Practice address
12936 63Rd Ave N
Maple Grove, MN 55369-6001
Phone
(763) 559-3400
Fax
(763) 559-3900
NPI assigned
Jun 19, 2010
Last updated
Jun 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2010

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

Authorized official

Name
Dr. Nasir LatifNPI 1306998265
Title
President
Phone
(612) 481-1976

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X D12215 MN Primary

Addresses

Primary practice location

12936 63Rd Ave N
Maple Grove, MN 55369-6001

Mailing address

12936 63Rd Ave N
Maple Grove, MN 55369-6001
Phone (763) 559-3400

National Provider Directory

National Provider Directory

Locations

12936 63rd Ave N
Maple Grove, MN 55369
Phone (763) 559-3400

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1276905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276905600000",
    "number": "1760703151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12936 63RD AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696001",
            "telephone_number": "763-559-3400",
            "fax_number": "763-559-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12936 63RD AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553696001",
            "telephone_number": "763-559-3400",
            "fax_number": "763-559-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AL SHIFA DENTISTRY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-19",
        "last_updated": "2010-06-19",
        "status": "A",
        "authorized_official_last_name": "LATIF",
        "authorized_official_first_name": "NASIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-481-1976",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D12215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2010; 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.