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INSIDE EDGE DENTAL PLLC NPI 1114360492


NPI Information

NPI: 1114360492
Provider Name: INSIDE EDGE DENTAL PLLC

Doing Business As: EAST DENTAL

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
1346 PAYNE AVE
SAINT PAUL, MN
ZIP 55130
Phone: (651) 774-6085
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INSIDE EDGE DENTAL PLLC is a general practice dentist in Saint Paul, MN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. INSIDE EDGE DENTAL PLLC NPI is 1114360492. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As East Dental.

The provider's business location address is:

1346 PAYNE AVE
SAINT PAUL, MN
ZIP 55130-434
Phone: (651) 774-6085
Fax: (651) 774-2660

The provider's authorized official is Jennifer A Marker Johnson .
The authorized official title is Dds/president and has the following contact phone number (651) 774-6085.

The enumeration date for this NPI number is 4/16/2013 and was last updated on 2/2/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral PracticeYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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