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MAHTOMEDI FAMILY DENTAL
NPI 1720415896
Dentist - General Practice in Mahtomedi, MN

Active since October 03, 2013
814 MAHTOMEDI AVE, MAHTOMEDI, MN 55115(651) 426-0011 Get Directions Write a Review

NPPES record last updated: October 3, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mahtomedi Family Dental NPPES

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

MAHTOMEDI FAMILY DENTAL (NPI 1720415896) is a healthcare organization registered as a general practice in Mahtomedi, Minnesota and active in the NPI registry since October 2013. The organization lists Brian Welle, Doctor, as its authorized official.

NPPES Registry Identity

NPI1720415896
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameMAHTOMEDI FAMILY DENTAL
Location Address814 MAHTOMEDI AVEMahtomedi, MN 55115-1730
Mailing Address814 Mahtomedi AveMahtomedi, MN 55115-1730
Phone(651) 426-0011
Organization SubpartNo
Authorized OfficialBrian WelleDoctor · (651) 426-0011
Enumeration DateOctober 3, 2013
✔ NPI 1720415896 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · D7721
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.

814 MAHTOMEDI AVE, Mahtomedi, MN 55115
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Other Identifiers 1

Medicaid1811212624MN

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 MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

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

MAHTOMEDI DENTAL CLINIC
Dentist (General Practice)
814 MAHTOMEDI AVE, MAHTOMEDI DENTAL
MAHTOMEDI, MN 55115
Washington County (651) 426-0011
MAHTOMEDI DENTAL CLINIC
Dentist (General Practice)
814 MAHTOMEDI AVE
MAHTOMEDI, MN 55115
Washington County (651) 426-0011
STEVEN HAGSTROM D.C.
Chiropractor
814 MAHTOMEDI AVE
MAHTOMEDI, MN 55115
Washington County (651) 426-2210
BRADLEY JOHN HAGEN
Dentist (General Practice)
814 MAHTOMEDI AVE
MAHTOMEDI, MN 55115
Washington County (651) 426-0011

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 Mahtomedi Family Dental's NPI number?

The NPI number for Mahtomedi Family Dental is 1720415896. It was assigned to this organization in the NPPES registry on October 3, 2013.

Where is Mahtomedi Family Dental located?

Mahtomedi Family Dental is located at 814 Mahtomedi Ave, Mahtomedi, MN 55115. The listed phone number is (651) 426-0011.

What is Mahtomedi Family Dental'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 Mahtomedi Family Dental was last updated on October 3, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.