Blaine Lakes Dental, P.L.L.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

BLAINE LAKES DENTAL, P.L.L.C.

Practice address

10705 Town Square Dr NE Ste 200
Blaine, MN 55449-8187

Phone

(763) 757-1535

NPI assigned

Sep 4, 2026

Last updated

Sep 4, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Firdavs Z Abzhabarov, DDS

Title

Dentist

Phone

(612) 563-9313

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1788480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1788480000000",
    "number": "1821907783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10705 TOWN SQUARE DR NE STE 200",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554498187",
            "telephone_number": "763-757-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10705 TOWN SQUARE DR NE STE 200",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554498187",
            "telephone_number": "763-757-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLAINE LAKES DENTAL, P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-04",
        "last_updated": "2026-09-04",
        "certification_date": "2026-09-04",
        "status": "A",
        "authorized_official_last_name": "ABZHABAROV",
        "authorized_official_first_name": "FIRDAVS",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "612-563-9313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blaine Dental LLC Dba Pro Dental
• Blaine Dentistry, PC (Blaine Dentistry)
• Blaine Health Services LLC
• Blaine Health Services LLC (Blaine Health - PCA Services LLC)
• Blaine Kidds Pediatric Dentistry PLLC
• Blaine MN Multi Specialty ASC LLC (North Metro Surgery Center)
• Blaine Orthodontics
• Blaine Urgency Center, LLC
• Blaine WP II, LLC
• Blaine WP, LLC

• General Practice Dentistry in Blaine, MN
• Providers in Blaine, 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 Sep 4, 2026; 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.