CEDAR RIVERSIDE DENTAL CLINIC
NPI 1124472402
Clinic/Center - Federally Qualified Health Center (FQHC) in Minneapolis, MN
NPI Status: Active since April 22, 2016
Contact Information
425 20TH AVE S
MINNEAPOLIS, MN
ZIP 55454
Phone: (612) 332-4973
Fax: (612) 238-3534
- Organization
- Clinic/Center
- Federally Qualified Health Center (FQHC)
- CLIA Number: 24D0403499
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 11-08-2027
About CEDAR RIVERSIDE DENTAL CLINIC
This page provides the complete NPI Profile along with additional information for Cedar Riverside Dental Clinic, a primary care provider established in Minneapolis, Minnesota operating as a Clinic/center, focusing in federally qualified health center (fqhc) . The healthcare provider is registered in the NPI registry with number 1124472402 assigned on April 2016. The practitioner's primary taxonomy code is 261QF0400X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's other name is Cedar Riverside Dental Clinic. The authorized official of this NPI record is Mrs. Sarah Noor Ceo (Ceo)
- NPI
- 1124472402
- Provider Legal Name
- CEDAR RIVERSIDE PEOPLE'S CENTER
- Other Organization Name
- CEDAR RIVERSIDE DENTAL CLINIC
- Other Name Type
- Other Name (5)
- Entity Type
- Organization
- Location Address
- 425 20TH AVE S MINNEAPOLIS, MN 55454
- Location Phone
- (612) 332-4973
- Location Fax
- (612) 238-3534
- Mailing Address
- 425 20TH AVE S MINNEAPOLIS, MN 55454
- Mailing Phone
- (612) 332-4973
- Mailing Fax
- (612) 238-3534
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 04-22-2016
- Last Update Date
- 06-06-2016
- Code Navigator
A primary care provider (PCP) like Cedar Riverside Dental Clinic sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
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
Clinic/Center Federally Qualified Health Center (FQHC)
- Taxonomy Code
- 261QF0400X
- Type
- Ambulatory Health Care Facilities
- License State
- MN
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
- 24D0403499
- Facility Type
- Community Clinic
- Certificate Effective Date
- November 09, 2025
- Certificate Expiration Date
- November 08, 2027
- Laboratory Director
- CYNTHIA WOODS
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Cedar Riverside 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 1124472402, we treat the final digit (2) 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 58. The final step is to find the difference between that total and the next multiple of ten (60 - 58 = 2).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 58 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
MINNEAPOLIS, MN 55454
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124472402, enumerated as an "organization" on April 22, 2016.
The provider is located at 425 20TH AVE S MINNEAPOLIS, MN 55454 and the phone number is (612) 332-4973.
Clinic/Center with taxonomy code 261QF0400X and a focus in Federally Qualified Health Center (FQHC).
