NPIMap

Organization Active NPI

Madison Avenue Family Dental Center, LTD

  • Dentist
  • Mankato, MN
National Provider Identifier
1912920059
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
8804 Issued in MN
Legal business name
MADISON AVENUE FAMILY DENTAL CENTER, LTD
Practice address
608 E Madison Ave
Mankato, MN 56001-6112
Phone
(507) 345-1284
Fax
(507) 345-5723
NPI assigned
Jul 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Mr. Kevin J. Torbenson, D.D.S.NPI 1710061163
Title
Co-Owner
Phone
(507) 345-1284

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 8804 MN Primary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X D11277 MN

Addresses

Primary practice location

608 E Madison Ave
Mankato, MN 56001-6112

Mailing address

608 E Madison Ave
Mankato, MN 56001-6112
Phone (507) 345-1284

Other identifiers 4

IdentifierTypeStateIssuer
D11277OtherMNNEUMANN, LICENSE #
5723159OtherMNMN TAX ID
8804OtherMNKEVIN TORBENSON, LICENSE
3273752000OtherMNUNEMPLOYMENT TAX ID

Other names 1

  • Advanced Dental Solutions Doing business as

National Provider Directory

National Provider Directory

Locations

608 Madison Ave
Mankato, MN 56001
Phone (507) 345-1284

Practitioners & affiliated clinicians

Practitioners 3

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1912920059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016112",
            "telephone_number": "507-345-1284",
            "fax_number": "507-345-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 E MADISON AVE",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560016112",
            "telephone_number": "507-345-1284",
            "fax_number": "507-345-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADISON AVENUE FAMILY DENTAL CENTER, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "TORBENSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "507-345-1284",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "8804",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11277",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEUMANN, LICENSE #",
            "identifier": "D11277",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN TAX ID",
            "identifier": "5723159",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEVIN TORBENSON, LICENSE",
            "identifier": "8804",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNEMPLOYMENT TAX ID",
            "identifier": "3273752000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Dental Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.