Great River Dental P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GREAT RIVER DENTAL P.A.

Practice address

375 Jackson St
Saint Paul, MN 55101-1810

Phone

(651) 222-0983

Fax

(651) 265-8036

NPI assigned

Dec 8, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Rozinka, DDS

Title

Owner

Phone

(651) 222-0986

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811972292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011806",
            "telephone_number": "651-222-0983",
            "fax_number": "651-265-8036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551011810",
            "telephone_number": "651-222-0983",
            "fax_number": "651-265-8036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT RIVER DENTAL P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROZINKA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-222-0986",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Saint Paul, MN
• Providers in Saint Paul, 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 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.