NPIMap

Organization Active NPI

Modern Dental Professionals MN PC

Doing business as Midwest Dental

  • Dentist
  • North Oaks, MN
National Provider Identifier
1861718173
Registry record updated Apr 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
MODERN DENTAL PROFESSIONALS MN PC
Doing business as
Midwest Dental
Practice address
200 Village Center Dr
Suite 400
North Oaks, MN 55127-7090
Phone
(651) 631-2133
NPI assigned
Apr 12, 2010
Last updated
Apr 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 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
Dentist 122300000X Primary

Addresses

Primary practice location

200 Village Center Dr
Suite 400
North Oaks, MN 55127-7090

Mailing address

200 Village Center Dr
Suite 400
North Oaks, MN 55127-7090
Phone (651) 631-2133

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

200 Village Center Dr
Ste 400
North Oaks, MN 55127
Phone (651) 631-2133

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": "1271030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271030400000",
    "number": "1861718173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR",
            "address_2": "SUITE 400",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551277090",
            "telephone_number": "651-631-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 VILLAGE CENTER DR",
            "address_2": "SUITE 400",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551277090",
            "telephone_number": "651-631-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN DENTAL PROFESSIONALS MN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-12",
        "last_updated": "2010-04-12",
        "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": "",
            "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 North Oaks, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.