Dental Center of America, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

D12186 Issued in MN

Legal business name

DENTAL CENTER OF AMERICA, PC

Practice address

1521 Northway Dr
Suite 102
Saint Cloud, MN 56303-4489

Phone

(320) 229-2205

Fax

(320) 229-2207

NPI assigned

Apr 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mohamed Hammam, DDS

Title

President

Phone

(320) 229-2205

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1972778561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1521 NORTHWAY DR",
            "address_2": "SUITE 102",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034489",
            "telephone_number": "320-229-2205",
            "fax_number": "320-229-2207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 NORTHWAY DR",
            "address_2": "SUITE 102",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563034489",
            "telephone_number": "320-229-2205",
            "fax_number": "320-229-2207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CENTER OF AMERICA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "HAMMAM",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "320-229-2205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MN",
            "license": "D12186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Dempsey, OD
• Katie Demuth
• Melonie Kay Demuth, RN
• Denise Oehrlein, LLC
• Jon E Dennis, MD, MPH, FAAP
• Kirk V. Denti
• Tracy Depa, RN
• Brent D Deragisch, DDS
• Holly Annette Derifield, LPN
• Dermatology Professionals PA

• Dental Clinic/Center in Saint Cloud, MN
• Providers in Saint Cloud, 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 Apr 24, 2008; 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.