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BIRCH LAKE DENTAL PA
NPI 1083853113
Dentist - General Practice in White Bear Lake, MN

Active since February 12, 2009
2641 WHITE BEAR PARKWAY, WHITE BEAR LAKE, MN 55110(651) 429-0404(651) 429-0472 Get Directions Write a Review

NPPES record last updated: February 12, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Birch Lake Dental Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BIRCH LAKE DENTAL PA (NPI 1083853113) is a healthcare organization registered as a general practice in White Bear Lake, Minnesota and active in the NPI registry since February 2009. The organization lists Geetha J Damodaran, Owner, as its authorized official.

NPPES Registry Identity

NPI1083853113
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameBIRCH LAKE DENTAL PA
Location Address2641 WHITE BEAR PARKWAYWhite Bear Lake, MN 55110
Mailing Address2641 White Bear ParkwayWhite Bear Lake, MN 55110 · (651) 429-0404 · Fax (651) 429-0472
Phone(651) 429-0404
Fax(651) 429-0472
Organization SubpartNo
Authorized OfficialGeetha J DamodaranOwner · (651) 429-0404
Enumeration DateFebruary 12, 2009
✔ NPI 1083853113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Licenses✔ Licensed in MN · D10949MN✔ Licensed in MN · 7712MN
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.
2641 WHITE BEAR PARKWAY, White Bear Lake, MN 55110
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Birch Lake Dental PA's NPI number?

The NPI number for Birch Lake Dental PA is 1083853113. It was assigned to this organization in the NPPES registry on February 12, 2009.

Where is Birch Lake Dental PA located?

Birch Lake Dental PA is located at 2641 White Bear Parkway, White Bear Lake, MN 55110. The listed phone number is (651) 429-0404.

What is Birch Lake Dental PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Birch Lake Dental PA was last updated on February 12, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.