Active NPI
Eagan Valley Dental Center P.a.
- Dentist
- Eagan, MN
National Provider Identifier
1902146335
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 09922
- Legal business name
- EAGAN VALLEY DENTAL CENTER P.A.
- Practice address
- 4555 Erin Dr
Eagan, MN 55122-3398 - Phone
- (651) 681-9044
- Fax
- (651) 681-0599
- NPI assigned
- Feb 21, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John David Mittelsteadt
- Title
- President
- Phone
- (651) 681-9044
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 09922 | MN | Primary |
Addresses
Primary practice location
4555 Erin Dr
Eagan, MN 55122-3398
Mailing address
4555 Erin Dr
Eagan, MN 55122-3398
Phone (651) 681-9044
National Provider Directory
National Provider Directory- Tax ID family
- Eagan Valley Dental Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Apple Valley, MN
- NPI 1073953832
Locations
4555 Erin Dr
Eagan, MN 55122
Phone (651) 681-9044
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Eagan, MN
- NPI 1649371063
-
- General Practice Dentistry
- Eagan, MN
- NPI 1508422411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1361404800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1361404800000",
"number": "1902146335",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4555 ERIN DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551223398",
"telephone_number": "651-681-9044",
"fax_number": "651-681-0599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4555 ERIN DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551223398",
"telephone_number": "651-681-9044",
"fax_number": "651-681-0599"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EAGAN VALLEY DENTAL CENTER P.A.",
"organizational_subpart": "NO",
"enumeration_date": "2013-02-21",
"last_updated": "2013-02-21",
"status": "A",
"authorized_official_last_name": "MITTELSTEADT",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "DAVID",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "651-681-9044",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "MN",
"license": "09922",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, MN
- Eagan Orthopedic Surgery Center LLC
- Eagan Pointe Senior Living
- Eagan Psychotherapy LLC (Apricity Counseling and Wellness LLC)
- Eagan Senior Living (Lexington Pointe Senior Living)
- Eagan Smiles Dentistry, PC (Eagan Smiles Dentistry)
- Eagancare Behavioral Health Services LLP.
- Madelin Eastman, PT
- Megan A Eastman, PHARMD, RPH
- Rebecca Eaton
- Adam Ebbers, D.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.