Chicago Lake Dental in Minneapolis - General Practice
Chicago Lake Dental - NPI 1497936389
Chicago Lake Dental is a General Practice in Minneapolis, Minnesota. Chicago Lake Dental practices all healthcare services and medical treatments related to General Practice. The NPI Number for Chicago Lake Dental is 1497936389. The last update date is 2007-11-19.
Chicago Lake Dental's current location address is 2900 Chicago Ave, Minneapolis, Minnesota. You can contact this provider via phone number 6128232080 and fax number 6128235777. The mailing address for Chicago Lake Dental is 2900 Chicago Ave, Minneapolis, Minnesota. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Chicago Lake Dental |
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Address | 2900 Chicago Ave, Minneapolis, Minnesota |
Phone Number | 6128232080 |
Fax Number | 6128235777 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | OWNER |
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Authorized Official Name | Johnson William David |
Credentials | DDS |
Telephone Number | 6128232080 |
NPI Number Detail
NPI Number | 1497936389 |
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Provider Enumeration Date | 2007-11-19 |
Last Updated Date | 2007-11-19 |
Provider Mailing Address Detail
Address | 2900 Chicago Ave |
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City | Minneapolis |
State | Minnesota (MN) |
Post Code | 554071322 |
Phone Number | 6128232080 |
Fax Number | 6128235777 |
Provider's Primary Taxonomy Detail
Speciality | General Practice |
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Taxonomy | 1223G0001X |
Licence No | D9512 |
Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique 10-digit identifier code issued to Chicago Lake Dental by the Centers for Medicare & Medicaid Services?
The Chicago Lake Dental has been assigned the NPI (National Provider Identifier) 1497936389 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Chicago Lake Dental?
The Chicago Lake Dental is physically situated at 2900 Chicago Ave, in the city of Minneapolis, state of MN, with the postal code 554071322.
What is Chicago Lake Dental's specialized field of practice, and what is the corresponding taxonomy classification code?
The Chicago Lake Dental's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
On what date did the Centers for Medicare & Medicaid Services assign the 1497936389 to Chicago Lake Dental?
The Centers for Medicare & Medicaid Services assigned the 1497936389 to Chicago Lake Dental on 2007-11-19.
When was the information pertaining to Chicago Lake Dental most recently updated or revised?
The details related to Chicago Lake Dental, including its address, specialty, and other relevant information, were last updated or revised on 2007-11-19.