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UNIVERSITY AVE DENTAL, PLLC
NPI 1093468852
Dentist - General Practice in Blaine, MN

Active since February 01, 2022
10155 UNIVERSITY AVE NE STE 112, BLAINE, MN 55434(763) 784-1242 Get Directions Write a Review

NPPES record last updated: February 1, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About University Ave Dental, Pllc NPPES

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

UNIVERSITY AVE DENTAL, PLLC (NPI 1093468852) is a healthcare organization registered as a general practice in Blaine, Minnesota and active in the NPI registry since February 2022. The organization lists Marty Spanish, Owner, as its authorized official.

NPPES Registry Identity

NPI1093468852
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameUNIVERSITY AVE DENTAL, PLLC
Location Address10155 UNIVERSITY AVE NE STE 112Blaine, MN 55434-8058
Mailing Address10155 University Ave Ne Ste 112Blaine, MN 55434-8058 · (763) 784-1242
Phone(763) 784-1242
Organization SubpartNo
Authorized OfficialMarty SpanishOwner · (952) 836-7924
Enumeration DateFebruary 1, 2022
NPPES CertifiedFebruary 1, 2022
✔ NPI 1093468852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
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.
10155 UNIVERSITY AVE NE STE 112, Blaine, MN 55434
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TAYLOR JOHNSON
Dentist (General Practice)
10155 UNIVERSITY AVE NE STE 112
BLAINE, MN 55434
Anoka County (763) 784-1242

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 University Ave Dental, PLLC's NPI number?

The NPI number for University Ave Dental, PLLC is 1093468852. It was assigned to this organization in the NPPES registry on February 1, 2022.

Where is University Ave Dental, PLLC located?

University Ave Dental, PLLC is located at 10155 University Ave NE Ste 112, Blaine, MN 55434. The listed phone number is (763) 784-1242.

What is University Ave Dental, PLLC'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 University Ave Dental, PLLC was last updated on February 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.