NPIMap

Organization Active NPI

Dr.Crandall D.D.S

  • Dentist
  • White Bear Lake, MN
National Provider Identifier
1780095828
Registry record updated May 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6428 Issued in MN
Legal business name
DR.CRANDALL D.D.S
Practice address
2300 Highway 96 E
White Bear Lake, MN 55110-2620
Phone
(651) 429-5354
Fax
(651) 653-0981
NPI assigned
May 12, 2014
Last updated
May 12, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2014

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

Authorized official

Name
Mrs. Anna Shelander
Title
Office Manager
Phone
(651) 429-5354

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6428 MN Primary

Addresses

Primary practice location

2300 Highway 96 E
White Bear Lake, MN 55110-2620

Mailing address

2300 Highway 96 E
White Bear Lake, MN 55110-2620
Phone (651) 429-5354

National Provider Directory

National Provider Directory

Locations

2300 Highway 96 E
White Bear Lake, MN 55110
Phone (651) 429-5354

Practitioners & affiliated clinicians

Practitioners 2

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": "1399852800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399852800000",
    "number": "1780095828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 96 E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551102620",
            "telephone_number": "651-429-5354",
            "fax_number": "651-653-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 HIGHWAY 96 E",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551102620",
            "telephone_number": "651-429-5354",
            "fax_number": "651-653-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR.CRANDALL D.D.S",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-12",
        "last_updated": "2014-05-12",
        "status": "A",
        "authorized_official_last_name": "SHELANDER",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "651-429-5354",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "6428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Bear Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2014; 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.