NPIMap

Organization Active NPI

Family & Cosmetic Gentle Dentistry, LTD.

  • General Practice Dentistry
  • Edina, MN
National Provider Identifier
1952399685
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FAMILY & COSMETIC GENTLE DENTISTRY, LTD.
Practice address
5100 Eden Ave Ste 209
Edina, MN 55436-2338
Phone
(952) 929-0641
NPI assigned
Oct 6, 2005
Last updated
Oct 28, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Authorized official

Name
Dr. Robert Luther Bodin, DDSNPI 1033109061
Title
President
Phone
(952) 224-9771

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X NU Primary
Prosthodontics 1223P0700X NU

Addresses

Primary practice location

5100 Eden Ave Ste 209
Edina, MN 55436-2338

Mailing address

6600 France Ave S Ste 415
Edina, MN 55435-1817
Phone (952) 224-9771

National Provider Directory

National Provider Directory
Tax ID family
Family and Cosmetic Gentle Dentistry16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

5100 Eden Ave
Ste 209
Edina, MN 55436
Phone (952) 929-0641

Practitioners & affiliated clinicians

Practitioners 4

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": "1128556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256688000000",
    "number": "1952399685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S STE 415",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351817",
            "telephone_number": "952-224-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 EDEN AVE STE 209",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554362338",
            "telephone_number": "952-929-0641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY & COSMETIC GENTLE DENTISTRY, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-06",
        "last_updated": "2009-10-28",
        "status": "A",
        "authorized_official_last_name": "BODIN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LUTHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-224-9771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.