NPIMap

Organization Active NPI

Eagan Dental Associates Dba Northwood Dental

  • General Practice Dentistry
  • Eagan, MN
National Provider Identifier
1891749362
Registry record updated Jun 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
10386 Issued in MN
Legal business name
EAGAN DENTAL ASSOCIATES DBA NORTHWOOD DENTAL
Practice address
1227 Northwood Pkwy
Eagan, MN 55121-4204
Phone
(651) 687-0789
Fax
(651) 687-0902
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2008

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

Authorized official

Name
Dr. Loren Jeffrey Taple, DDSNPI 1265537260
Title
DDS/Owner
Phone
(651) 687-0789

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 10386 MN Primary

Addresses

Primary practice location

1227 Northwood Pkwy
Eagan, MN 55121-4204

Mailing address

1227 Northwood Pkwy
Eagan, MN 55121-4204
Phone (651) 687-0789

Other identifiers 3

IdentifierTypeStateIssuer
1891749362MedicaidMN
405522500MedicaidMN
565522600MedicaidMN

National Provider Directory

National Provider Directory

Locations

1227 Northwood Pkwy
Eagan, MN 55121
Phone (651) 687-0789

Practitioners & affiliated clinicians

Practitioners 2

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": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214265600000",
    "number": "1891749362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 NORTHWOOD PKWY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551214204",
            "telephone_number": "651-687-0789",
            "fax_number": "651-687-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 NORTHWOOD PKWY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551214204",
            "telephone_number": "651-687-0789",
            "fax_number": "651-687-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGAN DENTAL ASSOCIATES DBA NORTHWOOD DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-06-24",
        "status": "A",
        "authorized_official_last_name": "TAPLE",
        "authorized_official_first_name": "LOREN",
        "authorized_official_middle_name": "JEFFREY",
        "authorized_official_title_or_position": "DDS/OWNER",
        "authorized_official_telephone_number": "651-687-0789",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "10386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1891749362",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405522500",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "565522600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; 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.