NPIMap

Organization Active NPI

Edlund Dental, LLC

  • General Practice Dentistry
  • Saint Paul, MN
National Provider Identifier
1821451774
Registry record updated Mar 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D12097 Issued in MN
Legal business name
EDLUND DENTAL, LLC
Practice address
1021 Bandana Blvd E
Suite #105
Saint Paul, MN 55108-5113
Phone
(651) 645-0449
NPI assigned
Mar 29, 2016
Last updated
Mar 29, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2016

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

Authorized official

Name
Dr. Steven Michael Edlund, D.D.S.NPI 1831373604
Title
Chief Manager
Phone
(651) 645-0449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X D12097 MN Primary

Addresses

Primary practice location

1021 Bandana Blvd E
Suite #105
Saint Paul, MN 55108-5113

Mailing address

1021 Bandana Blvd E
Suite #105
Saint Paul, MN 55108-5113
Phone (651) 645-0449

National Provider Directory

National Provider Directory

Locations

1021 Bandana Blvd E
Ste 105
Saint Paul, MN 55108
Phone (651) 645-0449

Practitioners & affiliated clinicians

Practitioners 1

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": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1821451774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE #105",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-645-0449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 BANDANA BLVD E",
            "address_2": "SUITE #105",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085113",
            "telephone_number": "651-645-0449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDLUND DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "EDLUND",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "651-645-0449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.