NORTHLAND ENDODONTICS PA NPI 1932200037

NPI Information

  • NPI: 1932200037
  • Provider Name: NORTHLAND ENDODONTICS PA
  • Classification: Dentist - 1223E0200X
  • Specialization: Endodontics
  • Entity Type: Organization
  • Address: 11800 ABERDEEN ST NE
    SUITE 140
    BLAINE, MN
    ZIP 55449
  • Phone: (763) 772-0330

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NPI Details

NORTHLAND ENDODONTICS PA is an endodontics dentist in Blaine, MN. The provider is the branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. NORTHLAND ENDODONTICS PA NPI is 1932200037. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11800 ABERDEEN ST NE
SUITE 140
BLAINE, MN
ZIP 55449-808
Phone: (763) 772-0330
Fax: (763) 772-0354

The provider's authorized official is Kris David Johnson .
The authorized official title is President and has the following contact phone number (763) 772-0330.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 8/22/2020.

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
11223E0200XDentistEndodonticsD10585MINNESOTAYes

What is NPI?

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This page was last updated on: 3/30/2025

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