CHASKA PEDIATRIC DENTISTRY P.A. NPI 1063834588

NPI Information

NPI: 1063834588
Provider Name: CHASKA PEDIATRIC DENTISTRY, P.A.

Doing Business As: TAILWIND PEDIATRIC DENTISTRY

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
111 HUNDERTMARK RD
SUITE 304N
CHASKA, MN
ZIP 55318
Phone: (952) 475-3135
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CHASKA PEDIATRIC DENTISTRY, P.A. is a dental clinic center in Chaska, MN. CHASKA PEDIATRIC DENTISTRY, P.A. NPI is 1063834588. The provider is registered as an organization entity type.
The provider Is Doing Business As Tailwind Pediatric Dentistry.

The provider's business location address is:

111 HUNDERTMARK RD
SUITE 304N
CHASKA, MN
ZIP 55318-551
Phone: (952) 475-3135

The provider's authorized official is Taylor Stephens .
The authorized official title is Owner/president and has the following contact phone number (952) 475-3135.

The enumeration date for this NPI number is 1/17/2014 and was last updated on 1/17/2014.

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
1	261QD0000X	Clinic/Center	Dental	D12818	MINNESOTA	Yes

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

NPI Synchronization or Removal

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