BLAINE ORTHODONTICS NPI 1659031854

NPI Information

  • NPI: 1659031854
  • Provider Name: BLAINE ORTHODONTICS
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 10945 CLUB WEST PKWY
    BLAINE, MN
    ZIP 55449
  • Phone: (763) 400-8992

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NPI Details

BLAINE ORTHODONTICS is a dental clinic center in Blaine, MN. BLAINE ORTHODONTICS NPI is 1659031854. The provider is registered as an organization entity type.

The provider's business location address is:

10945 CLUB WEST PKWY
BLAINE, MN
ZIP 55449-253
Phone: (763) 400-8992

The provider's authorized official is Tamara Smith .
The authorized official title is Orthodontist and has the following contact phone number (763) 400-8992.

The enumeration date for this NPI number is 12/29/2021 and was last updated on 12/29/2021.

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
1261QD0000XClinic/CenterDentalYes

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: 11/21/2025

NPI Synchronization or Removal

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