NISSWA DENTAL NPI 1801687173

NPI Information

  • NPI: 1801687173
  • Provider Name: NISSWA DENTAL
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 25579 CHURCH ST
    NISSWA, MN
    ZIP 56468
  • Phone: (218) 963-2970

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NPI Details

NISSWA DENTAL is a dental clinic center in Nisswa, MN. NISSWA DENTAL NPI is 1801687173. The provider is registered as an organization entity type.

The provider's business location address is:

25579 CHURCH ST
NISSWA, MN
ZIP 56468-834
Phone: (218) 963-2970

The provider's authorized official is Craig Brian Johnson .
The authorized official title is Owner / Dentist and has the following contact phone number (218) 963-2970.

The enumeration date for this NPI number is 5/15/2025 and was last updated on 5/15/2025.

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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