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GREAT LAKES ENDODONTICS
NPI 1104255371
Clinic/Center - Dental in Hermantown, MN

Active since November 07, 2013
4815 W ARROWHEAD RD, HERMANTOWN, MN 55811(218) 772-0772 Get Directions Write a Review

NPPES record last updated: November 7, 2013. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Great Lakes Endodontics NPPES

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

GREAT LAKES ENDODONTICS (NPI 1104255371) is a healthcare organization registered as a dental in Hermantown, Minnesota and active in the NPI registry since November 2013. The organization lists Mark Terrance Phillips, Dentist, as its authorized official.

NPPES Registry Identity

NPI1104255371
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameGREAT LAKES ENDODONTICS
Location Address4815 W ARROWHEAD RDHermantown, MN 55811-4004
Mailing Address4815 W Arrowhead RdHermantown, MN 55811-4004 · (218) 772-0772
Phone(218) 772-0772
Organization SubpartNo
Authorized OfficialMark Terrance PhillipsDentist · (651) 528-0240
Enumeration DateNovember 7, 2013
✔ NPI 1104255371 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in MN · D12534
4815 W ARROWHEAD RD, Hermantown, MN 55811
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Other Providers at the Same Location NPPES 5

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

WEIS EYE CENTER
Clinic/Center (Ophthalmologic Surgery)
4815 W ARROWHEAD RD, SUITE 120
HERMANTOWN, MN 55811
St. Louis County (218) 625-1917
BERNARD W HARRINGTON DDS
Dentist (Endodontics)
4815 W ARROWHEAD RD, SUITE #110
HERMANTOWN, MN 55811
St. Louis County (218) 722-0772
NORTHERN REFRACTIVE SURGERY CENTER LTD
Ophthalmology
4815 W ARROWHEAD RD, SUITE 120
HERMANTOWN, MN 55811
St. Louis County (218) 625-1917
DR. JEFFREY ROSS WEIS M.D.
Ophthalmology
4815 W ARROWHEAD RD, SUITE 120
HERMANTOWN, MN 55811
St. Louis County (218) 625-1917
PAMELA P HARRINGTON DDS MS
Dentist (Endodontics)
4815 W ARROWHEAD RD, SUITE #110
HERMANTOWN, MN 55811
St. Louis County (218) 722-0772

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 Great Lakes Endodontics's NPI number?

The NPI number for Great Lakes Endodontics is 1104255371. It was assigned to this organization in the NPPES registry on November 7, 2013.

Where is Great Lakes Endodontics located?

Great Lakes Endodontics is located at 4815 W Arrowhead Rd, Hermantown, MN 55811. The listed phone number is (218) 772-0772.

What is Great Lakes Endodontics's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Great Lakes Endodontics was last updated on November 7, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.