CENTRAL MN PEDIATRIC DENTISTS PA NPI 1144267063

NPI Information

  • NPI: 1144267063
  • Provider Name: CENTRAL MN PEDIATRIC DENTISTS PA
  • Classification: Dentist - 1223P0221X
  • Specialization: Pediatric Dentistry
  • Entity Type: Organization
  • Address: 1900 CENTRACARE CIRCLE
    STE 0350
    ST CLOUD, MN
    ZIP 56303
  • Phone: (320) 253-0272

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NPI Details

CENTRAL MN PEDIATRIC DENTISTS PA is a pediatric dentistry dentist in St Cloud, MN. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. CENTRAL MN PEDIATRIC DENTISTS PA NPI is 1144267063. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1900 CENTRACARE CIRCLE
STE 0350
ST CLOUD, MN
ZIP 56303-000
Phone: (320) 253-0272
Fax: (320) 251-2661

The provider's authorized official is Joseph Hall Wenner .
The authorized official title is President and has the following contact phone number (320) 253-0272.

The enumeration date for this NPI number is 5/31/2006 and was last updated on 6/18/2013.

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
11223P0221XDentistPediatric DentistryYes

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
1678350300MEDICAIDMINNESOTA
255520WEOTHERMINNESOTABCBS

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: 3/30/2025

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