NPIMap

Organization Active NPI

Childlren'S Dental Care LLC

  • Pediatric Dentistry
  • Lakeville, MN
National Provider Identifier
1942436167
Registry record updated Jun 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
7309 Issued in MN
Legal business name
CHILDLREN'S DENTAL CARE LLC
Practice address
17510 Dodd Blvd
Lakeville, MN 55044-5268
Phone
(952) 997-7100
Fax
(952) 997-2017
NPI assigned
Jun 2, 2009
Organization subpart
Yes
Parent organization
CHILDREN'S DENTAL CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 11, 2009

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

Authorized official

Name
Dr. George A Hankerson, DDS
Title
Dentist
Phone
(952) 997-7100

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 7309 MN Primary
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 11961 MN

Addresses

Primary practice location

17510 Dodd Blvd
Lakeville, MN 55044-5268

Mailing address

17510 Dodd Blvd
Lakeville, MN 55044-5268
Phone (952) 997-7100

National Provider Directory

National Provider Directory
Tax ID family
Children'S Dental Care2 organizations share this tax ID, including this one
Part of
Children'S Dental Care

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244678400000",
    "number": "1942436167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17510 DODD BLVD",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445268",
            "telephone_number": "952-997-7100",
            "fax_number": "952-997-2017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17510 DODD BLVD",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445268",
            "telephone_number": "952-997-7100",
            "fax_number": "952-997-2017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDLREN'S DENTAL CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHILDREN'S DENTAL CARE LLC",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-11",
        "status": "A",
        "authorized_official_last_name": "HANKERSON",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "952-997-7100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "7309",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "11961",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2009; 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.