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LONE OAK FAMILY DENTISTRY NPI 1053739698


NPI Information

NPI: 1053739698
Provider Name: LONE OAK FAMILY DENTISTRY
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
205 W JOHNSON AVE
STE. 3
WARREN, MN
ZIP 56762
Phone: (218) 745-4601
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LONE OAK FAMILY DENTISTRY is a general practice dentist in Warren, 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. LONE OAK FAMILY DENTISTRY NPI is 1053739698. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

205 W JOHNSON AVE
STE. 3
WARREN, MN
ZIP 56762-118
Phone: (218) 745-4601
Fax: (218) 745-4600

The provider's authorized official is Travis Ammen Hanel .
The authorized official title is Dentist and has the following contact phone number (218) 745-4601.

The enumeration date for this NPI number is 4/1/2014 and was last updated on 4/1/2014.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeD12024MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1473990600MEDICAIDMINNESOTA

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: 5/5/2024

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