CUSTOM SMILES DENTISTRY, PLLC
NPI 1528678497
Clinic/Center - Dental in Andover, MN

Q: What is Custom Smiles Dentistry, PLLC's NPI number?

The NPI number for Custom Smiles Dentistry, PLLC is 1528678497. It was assigned to this organization in the NPPES registry on August 5, 2020. The provider is doing business as Custom Smiles Dentistry.

Q: What is Custom Smiles Dentistry, PLLC's specialty?

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

Active since August 05, 2020

2258 BUNKER LAKE BLVD NW, ANDOVER, MN 55304(763) 390-8995(763) 390-8999 Get Directions Write a Review

NPPES record last updated: August 5, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Custom Smiles Dentistry, Pllc NPPES

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

CUSTOM SMILES DENTISTRY, PLLC (NPI 1528678497), doing business as Custom Smiles Dentistry, is a healthcare organization registered as a dental in Andover, Minnesota and active in the NPI registry since August 2020. The organization lists Pao Chua Vang, Dentist, as its authorized official.

NPPES Registry Identity

NPI1528678497

Entity TypeOrganization

Primary Taxonomy261QD0000X

Legal Business NameCUSTOM SMILES DENTISTRY, PLLC

Location Address2258 BUNKER LAKE BLVD NWAndover, MN 55304-3900

Mailing Address2258 Bunker Lake Blvd NwAndover, MN 55304-3900 · (763) 390-8995 · Fax (763) 390-8999

Phone(763) 390-8995

Fax(763) 390-8999

Organization SubpartNo

Authorized OfficialPao Chua VangDentist · (763) 390-8995

Enumeration DateAugust 5, 2020

NPPES CertifiedAugust 5, 2020

✔ NPI 1528678497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities

Taxonomy Code261QD0000X

2258 BUNKER LAKE BLVD NW, Andover, MN 55304

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Other Names 1

Doing Business AsCustom Smiles Dentistry

Other Providers at the Same Location NPPES

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

GRACIE ISABELLA COMEAU

Dental Therapist

2258 BUNKER LAKE BLVD NW
ANDOVER, MN 55304

Anoka County (793) 390-8995

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 Custom Smiles Dentistry, PLLC's NPI number?

The NPI number for Custom Smiles Dentistry, PLLC is 1528678497. It was assigned to this organization in the NPPES registry on August 5, 2020. The provider is doing business as Custom Smiles Dentistry.

Where is Custom Smiles Dentistry, PLLC located?

Custom Smiles Dentistry, PLLC is located at 2258 Bunker Lake Blvd NW, Andover, MN 55304. The listed phone number is (763) 390-8995.

What is Custom Smiles Dentistry, PLLC'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 Custom Smiles Dentistry, PLLC was last updated on August 5, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.