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ADT KIDS DENTAL SERVICES PA NPI 1679911531


NPI Information

NPI: 1679911531
Provider Name: ADT KIDS DENTAL SERVICES PA
Classification: Dental Therapist - 125J00000X
Entity Type: Organization
Address:
2232 HENNEPIN AVE
MINNEAPOLIS, MN
ZIP 55405
Phone: (612) 377-6108
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ADT KIDS DENTAL SERVICES PA is a dental therapist in Minneapolis, MN. The provider is a Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. ADT KIDS DENTAL SERVICES PA NPI is 1679911531. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2232 HENNEPIN AVE
MINNEAPOLIS, MN
ZIP 55405-737
Phone: (612) 377-6108
Fax: (612) 374-1820

The provider's authorized official is Jamee Rosell .
The authorized official title is Executive Director and has the following contact phone number (612) 377-6108.

The enumeration date for this NPI number is 6/12/2013 and was last updated on 6/12/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223D0001XDentistDental Public HealthD9933MINNESOTANo
21223D0001XDentistDental Public HealthD9919MINNESOTANo
3125J00000XDental TherapistDT3MINNESOTAYes

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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