PL Dental SC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

PL DENTAL SC

Practice address

1014 Dale St N
Saint Paul, MN 55117-5603

Phone

(678) 588-4533

NPI assigned

Oct 29, 2025

Organization subpart

Yes

Parent organization

PL DENTAL SCAs reported in NPPES

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

Authorized official

Name

Phong Ly, DDSNPI 1790131761

Title

Owner Doctor

Phone

(763) 377-2110

Specialties & licenses 1

Addresses

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.

• PL Dental SC

  • Dental Clinic/Center
  • Zimmerman, MN
  • NPI 1225786411
  NPD tax ID
• PL Dental SC

  • Dental Clinic/Center
  • Coon Rapids, MN
  • NPI 1952140691
  NPD tax ID

Locations

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.

• PL Dental SC

  • Dental Clinic/Center
  • Zimmerman, MN
  • NPI 1225786411
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Phong Ly, DDS

  • Dentist
  • Coon Rapids, MN
  • NPI 1790131761
  NPD (past) Authorized official

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761696000000",
    "number": "1972471944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1014 DALE ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551175603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 DALE ST N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551175603",
            "telephone_number": "678-588-4533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PL DENTAL SC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PL DENTAL SC",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A",
        "authorized_official_last_name": "LY",
        "authorized_official_first_name": "PHONG",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "763-377-2110",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Everett Pittman, PHARM.D.
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• Dawn Pivec
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• Plastic Surgery Associates, P.a.
• Plastic Surgery Consultants

• Dental Clinic/Center in Saint Paul, MN
• Providers in Saint Paul, 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 Oct 29, 2025; 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.