MINNESOTA VETERANS HOMES DENTAL CLINIC
NPI 1083310403
Dentist - General Practice in Silver Bay, MN

NPI Status: Active since February 07, 2023

Contact Information

56 OUTER DR
SILVER BAY, MN
ZIP 55614
Phone: (218) 353-8700
Fax: (612) 548-5964

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  • Organization
  • Dentist
  • General Practice
  • CLIA Number: 24D2190452
  • CLIA Cert. Type: Skilled Nursing Facility/Nursing Facility
  • CLIA Exp. Date: 08-12-2026

About MINNESOTA VETERANS HOMES DENTAL CLINIC

This page provides the complete NPI Profile along with additional information for Minnesota Veterans Homes Dental Clinic, a provider established in Silver Bay, Minnesota operating as a Dentist, focusing in general practice . The healthcare provider is registered in the NPI registry with number 1083310403 assigned on February 2023. The practitioner's primary taxonomy code is 1223G0001X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Minnesota Veterans Homes Dental Clinic. The authorized official of this NPI record is Simone Renee Hogan (Mdva Chief Operations Director)

NPI
1083310403
Provider Legal Name
STATE OF MINNESOTA MINNESOTA MANAGEMENT AND BUDGET
Other Organization Name
MINNESOTA VETERANS HOMES DENTAL CLINIC
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
56 OUTER DR SILVER BAY, MN 55614
Location Phone
(218) 353-8700
Location Fax
(612) 548-5964
Mailing Address
5101 MINNEHAHA AVE. S MINNEAPOLIS, MN 55417
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
02-07-2023
Last Update Date
12-03-2024
Code Navigator

A dentist like Minnesota Veterans Homes Dental Clinic is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist General Practice

Taxonomy Code
1223G0001X
Type
Dental Providers
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

SIMONE RENEE HOGAN

Authorized Official Title
MDVA CHIEF OPERATIONS DIRECTOR
Authorized Official Phone
(612) 505-4110

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
24D2190452
Facility Type
Skilled Nursing Facility/Nursing Facility
Certificate Effective Date
August 13, 2024
Certificate Expiration Date
August 12, 2026
Laboratory Director
SEAN C. ERCAN-FANG
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Minnesota Veterans Homes Dental Clinic to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1083310403, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
8
Doubled → 16 → 1 + 6
Pos 4
3
Unchanged
Pos 5
3
Doubled → 6
Pos 6
1
Unchanged
Pos 7
0
Doubled → 0
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 8 → 16 → 7 3 → 6 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 6 + 3 + 6 + 1 + 0 + 4 + 0 + 24 = 47

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 47 is 50. The difference is the calculated check digit.

50 - 47 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1083310403.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Nurse Practitioner (Family)
56 OUTER DR
SILVER BAY, MN 55614
Skilled Nursing Facility
56 OUTER DR
SILVER BAY, MN 55614

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1083310403, enumerated as an "organization" on February 07, 2023.

The provider is located at 56 OUTER DR SILVER BAY, MN 55614 and the phone number is (218) 353-8700.

Dentist with taxonomy code 1223G0001X and a focus in General Practice.