Burnsville Dental, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11856 Issued in MN

Legal business name

BURNSVILLE DENTAL, P.A.

Doing business as

Northstar Dental Clinic

Practice address

675 E Nicollet Blvd Ste 120
Burnsville, MN 55337-6748

Phone

(952) 892-7700

NPI assigned

Oct 7, 2011

Organization subpart

No

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

Authorized official

Name

Isabella Constantin

Title

Business Manager

Phone

(952) 892-7700

Specialties & licenses 3

Addresses

Other names 1

• Northstar Dental Clinic Doing business as

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

{
    "created_epoch": "1317945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317945600000",
    "number": "1891079851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 E NICOLLET BLVD STE 120",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376748",
            "telephone_number": "952-892-7700",
            "fax_number": "952-892-7767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 E NICOLLET BLVD STE 120",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376748",
            "telephone_number": "952-892-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BURNSVILLE DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-07",
        "last_updated": "2011-10-07",
        "status": "A",
        "authorized_official_last_name": "CONSTANTIN",
        "authorized_official_first_name": "ISABELLA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "952-892-7700"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10615",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11856",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12917",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northstar Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Burnsville Orthodontic Associates PLLC (Ekim Orthodontics)
• Burnsville Surgery Center, P.a.

• General Practice Dentistry in Burnsville, MN
• Providers in Burnsville, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.