NPIMap

Organization Active NPI

Dentalign, P.a

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Edina, MN
National Provider Identifier
1871837708
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
DENTALIGN, P.A
Practice address
4630 Edgebrook PL
Edina, MN 55424-1152
Phone
(763) 420-1030
Fax
(730) 420-5510
NPI assigned
Nov 15, 2012
Last updated
Nov 15, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Authorized official

Name
Dr. Chad Holly Kelly, D.M.D.
Title
President
Phone
(763) 420-1030

Specialties & licenses 1

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

Addresses

Primary practice location

4630 Edgebrook PL
Edina, MN 55424-1152

Mailing address

10617 France Avenue S
Bloomington, MN 55431
Phone (763) 420-1030

National Provider Directory

National Provider Directory
Tax ID family
Dentalign PA6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Locations

10617 France Ave S
Bloomington, MN 55431

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1871837708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10617 FRANCE AVENUE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "55431",
            "telephone_number": "763-420-1030",
            "fax_number": "430-420-5510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 EDGEBROOK PL",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241152",
            "telephone_number": "763-420-1030",
            "fax_number": "730-420-5510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTALIGN, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "HOLLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "763-420-1030",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "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 Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.