Twin Cities Sedation Dental, P.a.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TWIN CITIES SEDATION DENTAL, P.A.

Practice address

808 W Broadway Ave
Suite a
Forest Lake, MN 55025-3769

Phone

(651) 674-7096

NPI assigned

Nov 10, 2014

Last updated

Nov 10, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sarah M Burt, RDH, MDH

Title

Operations Director

Phone

(651) 674-7096

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1415577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1932505583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6460 MAIN ST",
            "city": "NORTH BRANCH",
            "state": "MN",
            "postal_code": "550567068",
            "telephone_number": "651-674-7096",
            "fax_number": "651-203-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W BROADWAY AVE",
            "address_2": "SUITE A",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550253769",
            "telephone_number": "651-674-7096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES SEDATION DENTAL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-10",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "BURT",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "651-674-7096",
        "authorized_official_credential": "RDH, MDH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Trejo-Monson, L.AC. R.N.
• Lauren Trempe
• Rachael Marie Tschida
• Stephanie L Tschida, LMFT
• Thomas Scott Turry, D.D.S.
• Kathryn Hartman Valine, MA
• Jenny Valkos, MSW, LICSW, LADC
• Ellen Van Tassel, MA, CCC-SLP
• Rebecca Varoga, PT, DPT
• Raymond Keith Vellenga, RPH

• Dental Clinic/Center in Forest Lake, MN
• Providers in Forest Lake, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 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.