NPIMap

Organization Active NPI

Centennial Lakes Dental Group

  • Dentist
  • Edina, MN
National Provider Identifier
1801982111
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
CENTENNIAL LAKES DENTAL GROUP
Practice address
7373 France Ave S Ste 500
Edina, MN 55435-4551
Phone
(952) 831-2800
Fax
(952) 831-5805
NPI assigned
Oct 5, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Judy Slavik
Title
Office Manager
Phone
(952) 831-2800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

7373 France Ave S Ste 500
Edina, MN 55435-4551

Mailing address

7373 France Ave S Ste 500
Edina, MN 55435-4551
Phone (952) 831-2800

National Provider Directory

National Provider Directory
Tax ID family
Centennial Lakes Dental Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7373 France Ave S
Ste 500
Edina, MN 55435
Phone (952) 831-2800

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1801982111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 500",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354551",
            "telephone_number": "952-831-2800",
            "fax_number": "952-831-5805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 FRANCE AVE S STE 500",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554354551",
            "telephone_number": "952-831-2800",
            "fax_number": "952-831-5805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL LAKES DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SLAVIK",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-831-2800",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.