NPIMap

Organization Active NPI

Northland Dental Partners, PLLC

Doing business as Metro Dentalcare St. Louis Park

  • General Practice Dentistry
  • St Louis Park, MN
National Provider Identifier
1801043096
Registry record updated Mar 15, 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
Practice address
4959 Excelsior Blvd Ste 200
St Louis Park, MN 55416-3003
Phone
(952) 920-8774
NPI assigned
Aug 19, 2008
Last updated
Mar 15, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHLAND DENTAL PARTNERS, PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 15, 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 Dentistry 1223G0001X NU Primary

Addresses

Primary practice location

4959 Excelsior Blvd Ste 200
St Louis Park, MN 55416-3003

Mailing address

4959 Excelsior Blvd Ste 200
St Louis Park, MN 55416-3003
Phone (952) 920-8774

Other names 1

  • Metro Dentalcare St. Louis Park 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

3030 Centre Pointe Dr
Saint Paul, MN 55113
Phone (651) 286-8100

4959 Excelsior Blvd
St Louis Park, MN 55416

Practitioners & affiliated clinicians

Practitioners 8

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": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1647302400000",
    "number": "1801043096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 EXCELSIOR BLVD STE 200",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163003",
            "telephone_number": "952-920-8774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 EXCELSIOR BLVD STE 200",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163003",
            "telephone_number": "952-920-8774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHLAND DENTAL PARTNERS, PLLC",
        "enumeration_date": "2008-08-19",
        "last_updated": "2022-03-15",
        "certification_date": "2022-03-15",
        "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": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Metro Dentalcare St. Louis Park",
            "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 Mar 15, 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.