Organization Active NPI

Paynesville Family Dental

  • Dentist
  • Paynesville, MN
National Provider Identifier
1881013019
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12231 Issued in MN
Legal business name
PAYNESVILLE FAMILY DENTAL
Practice address
204 W James St
Paynesville, MN 56362-1219
Phone
(320) 243-7209
NPI assigned
Apr 15, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
Dr. Chris McGrew
Title
General Dentist
Phone
(320) 243-7209

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12231 MN Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 12437 MN

Addresses

Primary practice location

204 W James St
Paynesville, MN 56362-1219

Mailing address

204 W James St
Paynesville, MN 56362-1219
Phone (320) 243-7209

National Provider Directory

National Provider Directory

Locations

204 W James St
Paynesville, MN 56362
Phone (320) 243-7209

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1881013019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W JAMES ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621219",
            "telephone_number": "320-243-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W JAMES ST",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563621219",
            "telephone_number": "320-243-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAYNESVILLE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "MCGREW",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "GENERAL DENTIST",
        "authorized_official_telephone_number": "320-243-7209",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "12231",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "12437",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paynesville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.