NPIMap

Organization Active NPI

Smile Orthodontics Stillwater LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Maple Grove, MN
National Provider Identifier
1821690496
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
SMILE ORTHODONTICS STILLWATER LLC
Practice address
9424 Maple Grove Pkwy N
Maple Grove, MN 55311-5499
Phone
(651) 351-7777
NPI assigned
Nov 9, 2020
Organization subpart
Yes
Parent organization
SMILE ORTHODONTICSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Douglas Wolff, DDS
Title
Owner/DDS
Phone
(651) 351-7777

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

9424 Maple Grove Pkwy N
Maple Grove, MN 55311-5499

Mailing address

1041 Grand Ave # 531
Saint Paul, MN 55105-3002
Phone (651) 351-7777

National Provider Directory

National Provider Directory
Tax ID family
Smile Orthodontics Stillwater LLC5 organizations share this tax ID, including this one
Part of
Smile Orthodontics Stillwater LLC

Other organizations with this tax ID 4

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

Locations

9424 Dunkirk Ln N
Maple Grove, MN 55311

9424 Maple Grove Pkwy N
Maple Grove, MN 55311

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1821690496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1041 GRAND AVE # 531",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053002",
            "telephone_number": "651-351-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9424 MAPLE GROVE PKWY N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553115499",
            "telephone_number": "651-351-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE ORTHODONTICS STILLWATER LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SMILE ORTHODONTICS",
        "enumeration_date": "2020-11-09",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/DDS",
        "authorized_official_telephone_number": "651-351-7777",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maple Grove, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.