NPIMap

Organization Active NPI

Modern Dental Professionals Minnesota PC

Doing business as Midwest Dental

  • Dentist
  • Hastings, MN
National Provider Identifier
1861714792
Registry record updated Feb 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MODERN DENTAL PROFESSIONALS MINNESOTA PC
Doing business as
Midwest Dental
Practice address
925 Highway 55
Suite #102
Hastings, MN 55033-3734
Phone
(651) 437-7844
Fax
(651) 437-3454
NPI assigned
Feb 19, 2010
Last updated
Feb 19, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2010

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

Authorized official

Name
James Myer
Title
Cfo
Phone
(715) 926-5050

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

925 Highway 55
Suite #102
Hastings, MN 55033-3734

Mailing address

680 Hehli Way
Mondovi, WI 54755-1639
Phone (715) 926-5050

Other names 1

  • Midwest Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Midwest Dental39 organizations share this tax ID, including this one

Other organizations with this tax ID 38

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

View all 38

Locations

925 Highway 55
Ste 102
Hastings, MN 55033
Phone (651) 437-7844

Practitioners & affiliated clinicians

Practitioners 5

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": "1266537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266537600000",
    "number": "1861714792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 HEHLI WAY",
            "city": "MONDOVI",
            "state": "WI",
            "postal_code": "547551639",
            "telephone_number": "715-926-5050",
            "fax_number": "715-926-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 HIGHWAY 55",
            "address_2": "SUITE #102",
            "city": "HASTINGS",
            "state": "MN",
            "postal_code": "550333734",
            "telephone_number": "651-437-7844",
            "fax_number": "651-437-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS MINNESOTA PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-19",
        "last_updated": "2010-02-19",
        "status": "A",
        "authorized_official_last_name": "MYER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "715-926-5050"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hastings, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.