NPIMap

Organization Active NPI

Northland Dental Partners, PLLC

Doing business as Metro Dentalcare St. Louis Park West 36th Street

  • General Practice Dentistry
  • St Louis Park, MN
National Provider Identifier
1790435428
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
NORTHLAND DENTAL PARTNERS, PLLC
Doing business as
Metro Dentalcare St. Louis Park West 36th Street
Practice address
5806 W 36TH St Ste a
St Louis Park, MN 55416-5108
Phone
(952) 929-5292
Fax
(952) 988-5890
NPI assigned
Mar 25, 2022
Organization subpart
Yes
Parent organization
NORTHLAND DENTAL PARTNERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Authorized official

Name
Celia Hayes
Title
Credentialing Coordinator
Phone
(217) 540-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

5806 W 36TH St Ste a
St Louis Park, MN 55416-5108

Mailing address

5806 W 36TH St Ste a
St Louis Park, MN 55416-5108
Phone (952) 929-5292

Other names 1

  • Metro Dentalcare St. Louis Park West 36th Street Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Northland Dental Partners43 organizations share this tax ID, including this one
Part of
Northland Dental Partners

Other organizations with this tax ID 42

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

View all 42

Locations

5806 W 36th St
#A
St Louis Park, MN 55416
Phone (952) 856-8596

5806 W 36th St
Ste 500
St Louis Park, MN 55416

NPI Registry JSON

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651449600000",
    "number": "1790435428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5806 W 36TH ST STE A",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165108",
            "telephone_number": "952-929-5292",
            "fax_number": "952-988-5890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5806 W 36TH ST STE A",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554165108",
            "telephone_number": "952-929-5292",
            "fax_number": "952-988-5890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "enumeration_date": "2022-03-25",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "CELIA",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "217-540-2100"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dentalcare St. Louis Park West 36th Street",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Metro Dentalcare St. Louis Park West 36th Street",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Louis Park, MN

Sources for this page

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