Rksa Dental Enterprises PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RKSA DENTAL ENTERPRISES PLLC

Doing business as

Crystal Lake Dental Care

Practice address

3925 37TH Ave N
Robbinsdale, MN 55422-2357

Phone

(763) 588-8426

NPI assigned

Sep 2, 2020

Organization subpart

No

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

Authorized official

Name

Sam Jacobson

Title

Business Manager

Phone

(763) 588-8426

Specialties & licenses 1

Addresses

Other names 1

• Crystal Lake Dental Care Doing business as

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• James R. Gaasedelen, DDS

  • General Practice Dentistry
  • Robbinsdale, MN
  • NPI 1558377994
  NPD (past)

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

{
    "created_epoch": "1599004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599004800000",
    "number": "1831703347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3925 37TH AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222357",
            "telephone_number": "763-588-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 37TH AVE N",
            "city": "ROBBINSDALE",
            "state": "MN",
            "postal_code": "554222357",
            "telephone_number": "763-588-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RKSA DENTAL ENTERPRISES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A",
        "authorized_official_last_name": "JACOBSON",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "763-588-8426"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crystallakedental@comcast.net",
            "affiliation": "N",
            "address_1": "3925 37th Ave N",
            "city": "Robbinsdale",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554222357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Crystal Lake Dental Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rising Sun Healing Arts
• Beth Ristow
• Alexandra Ritts, MD
• Leanne Ritz
• Kareem Rizk, PA
• Robbinsdale Chirocenter Inc.
• Robbinsdale Chiropractic
• Robbinsdale Clinic, P.a.
• Robbinsdale Dental PLLC
• Robbinsdale Dentalcare PA

• Dental Clinic/Center in Robbinsdale, MN
• Providers in Robbinsdale, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.