NPIMap

Organization Active NPI

PL Dental SC

  • Dental Clinic/Center
  • Coon Rapids, MN
National Provider Identifier
1952140691
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
PL DENTAL SC
Practice address
9920 Foley Blvd NW Ste 110
Coon Rapids, MN 55433-5216
Phone
(763) 317-1166
NPI assigned
May 22, 2024
Last updated
May 22, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
PL DENTAL SCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Authorized official

Name
Phong Vinh LyNPI 1790131761
Title
Office Manager
Phone
(763) 317-1166

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
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

9920 Foley Blvd NW Ste 110
Coon Rapids, MN 55433-5216

Mailing address

9920 Foley Blvd NW Ste 110
Minneapolis, MN 55433-5216
Phone (763) 317-1166

National Provider Directory

National Provider Directory
Tax ID family
PL Dental SC3 organizations share this tax ID, including this one
Part of
PL Dental SC

Other organizations with this tax ID 2

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 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1716336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716336000000",
    "number": "1952140691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9920 FOLEY BLVD NW STE 110",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554335216",
            "telephone_number": "763-317-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9920 FOLEY BLVD NW STE 110",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335216",
            "telephone_number": "763-317-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PL DENTAL SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PL DENTAL SC",
        "enumeration_date": "2024-05-22",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "PHONG",
        "authorized_official_middle_name": "VINH",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "763-317-1166"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coon Rapids, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.