G2 South

Primary specialty

DentistTaxonomy code 122300000X

License

8109 Issued in MN

Legal business name

G2 SOUTH

Practice address

5846 Blackshire Path
Inver Grove Heights, MN 55016

Phone

(651) 389-1133

Fax

(651) 389-1135

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Tracey M Koctt

Title

Practice Manager

Phone

(651) 389-1133

Specialties & licenses 2

Addresses

Tax ID family

G2 South2 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.

• G2 South PLLC

  • Dentist
  • Inver Grove Heights, MN
  • NPI 1023127388
  NPD tax ID

Locations

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821079583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5846 BLACKSHIRE PATH",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "55016",
            "telephone_number": "651-389-1133",
            "fax_number": "651-389-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5846 BLACKSHIRE PATH",
            "city": "INVER GROVE HEIGHTS",
            "state": "MN",
            "postal_code": "55016",
            "telephone_number": "651-389-1133",
            "fax_number": "651-389-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G2 SOUTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOCTT",
        "authorized_official_first_name": "TRACEY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "651-389-1133",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "8109",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "9975",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Forschen
• Jacquelyn Anne Fox, RN
• Anna Marie Francke, DDS
• Erin Elizabeth Frawley, MS, LPCC
• Ann Friedges, PT, DPT
• G2 South PLLC
• Joan Marie Gabriel, LICSW
• Lonnie R Gabrielson, PHARMD
• Sean Gallagher, MD
• Amanda Marie Gallahue

• Dentist in Inver Grove Heights, MN
• Providers in Inver Grove Heights, MN by specialty
• Dentist 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.