MAPLE GROVE FAMILY DENTAL CLINIC, PA
NPI 1922181197
Dentist - General Practice in Maple Grove, MN

Q: What is Maple Grove Family Dental Clinic, PA's NPI number?

The NPI number for Maple Grove Family Dental Clinic, PA is 1922181197. It was assigned to this organization in the NPPES registry on October 23, 2006.

Q: What is Maple Grove Family Dental Clinic, PA's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since October 23, 2006

12000 ELM CREEK BLVD N, SUITE #220, MAPLE GROVE, MN 55369(763) 420-4421(763) 420-5674 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Maple Grove Family Dental Clinic, Pa NPPES

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

MAPLE GROVE FAMILY DENTAL CLINIC, PA (NPI 1922181197) is a healthcare organization registered as a general practice in Maple Grove, Minnesota and active in the NPI registry since October 2006. The organization lists Susan M. Larson, Clinic Administrator, as its authorized official.

NPPES Registry Identity

NPI1922181197

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameMAPLE GROVE FAMILY DENTAL CLINIC, PA

Location Address12000 ELM CREEK BLVD N, SUITE #220Maple Grove, MN 55369-7073

Mailing Address12000 Elm Creek Blvd N, Suite #220Maple Grove, MN 55369-7073 · (763) 420-4421 · Fax (763) 420-5674

Phone(763) 420-4421

Fax(763) 420-5674

Organization SubpartNo

Authorized OfficialSusan M. LarsonClinic Administrator · (763) 420-4421

Enumeration DateOctober 23, 2006

Last NPPES UpdateAugust 22, 2020

✔ NPI 1922181197 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Licenses✔ Licensed in MN · D11341✔ Licensed in MN · 9790✔ Licensed in MN · 10067

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.

12000 ELM CREEK BLVD N, Maple Grove, MN 55369

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Other Identifiers 1

Other10656MN · Bluecrossblue Shield

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 20

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

JAMIE LAWLESS CMT

Contractor

12000 ELM CREEK BLVD N, SUITE L70
MAPLE GROVE, MN 55369

Hennepin County (763) 463-9444

SHANE A. BORODITSKY, P.A.

Chiropractor

12000 ELM CREEK BLVD N
MAPLE GROVE, MN 55369

Hennepin County (612) 281-3575

MIRTHA NESHEIM M.D.

Family Medicine

12000 ELM CREEK BLVD N
MAPLE GROVE, MN 55369

Hennepin County (763) 420-5822

MS. GAY WYNNE LENTFER PA

Physician Assistant

12000 ELM CREEK BLVD N
MAPLE GROVE, MN 55369

Hennepin County (763) 420-5822

MICHAEL A GALLAGHER FNP

Nurse Practitioner (Occupational Health)

12000 ELM CREEK BLVD N, #140
MAPLE GROVE, MN 55369

Hennepin County (763) 420-7048

JAMIE L SLEDD

Clinic/Center (Dental)

12000 ELM CREEK BLVD N, SUITE 230
MAPLE GROVE, MN 55369

Hennepin County (763) 494-4443

DR. JAMIE LIN SLEDD DDS

Dentist (General Practice)

12000 ELM CREEK BLVD N, SUITE 230
MAPLE GROVE, MN 55369

Hennepin County (763) 494-4443

KAREN LYNN SCULLY ATC

Specialist/Technologist (Athletic Trainer)

12000 ELM CREEK BLVD N, #120
MAPLE GROVE, MN 55369

Hennepin County (763) 420-9960

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 Maple Grove Family Dental Clinic, PA's NPI number?

The NPI number for Maple Grove Family Dental Clinic, PA is 1922181197. It was assigned to this organization in the NPPES registry on October 23, 2006.

Where is Maple Grove Family Dental Clinic, PA located?

Maple Grove Family Dental Clinic, PA is located at 12000 Elm Creek Blvd N Suite #220, Maple Grove, MN 55369. The listed phone number is (763) 420-4421.

What is Maple Grove Family Dental Clinic, PA'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 Maple Grove Family Dental Clinic, PA was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.