Gossai & Knutson, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12778 Issued in MN

Legal business name

GOSSAI & KNUTSON, DDS, PA

Doing business as

Southill Dental Group PA

Practice address

2850 Curve Crest Blvd W
Suite 200
Stillwater, MN 55082-4039

Phone

(651) 439-9400

Fax

(651) 439-9402

NPI assigned

Apr 25, 2007

Last updated

Apr 2, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Donna Kobs

Title

Office Manager

Phone

(651) 439-9400

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• Southill Dental Group PA Doing business as

Locations

Practitioners 4

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.

• Carson Cannon, D.D.S.

  • Dentist
  • Stillwater, MN
  • NPI 1063078210

  General Practice

  NPD (past)
• Philip V. Flodin

  • General Practice Dentistry
  • Stillwater, MN
  • NPI 1184616005
  NPD (past)
• Krista Noel Gossai, D.D.S.

  • General Practice Dentistry
  • Stillwater, MN
  • NPI 1831419209
  NPD (past)
• Carissa Knutson, D.D.S

  • General Practice Dentistry
  • Stillwater, MN
  • NPI 1477692903
  NPD (past)

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1770702714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 CURVE CREST BLVD W",
            "address_2": "SUITE 200",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824039",
            "telephone_number": "651-439-9400",
            "fax_number": "651-439-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 CURVE CREST BLVD W",
            "address_2": "SUITE 200",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824039",
            "telephone_number": "651-439-9400",
            "fax_number": "651-439-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOSSAI & KNUTSON, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "KOBS",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-439-9400"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "12778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477692903",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "293218100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GOSSAI",
            "identifier": "1831419209",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1831419209",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9909",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI - FLODIN",
            "identifier": "1184616005",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI KNUTSON",
            "identifier": "1477692903",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "H. PARTNER ID - FLODIN",
            "identifier": "18386",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southill Dental Group PA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Marie Gleich, MA, LP
• Margaret Elizabeth Glennon, PA-C
• Adam D Goddard, D.O.
• Cynthia G. Goetz, PA-C
• Shannon Lynn Gonnion, P.A.
• Krista Noel Gossai, D.D.S.
• Nicolette Gott, PHARM D
• Kaitlyn Goulet, M.S. CCC-SLP
• Grace Medical Inc.
• Grand St Paul CVS LLC (CVS Pharmacy #16353)

• General Practice Dentistry in Stillwater, MN
• Providers in Stillwater, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.