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Contact Information

NICOLLET DENTAL
6101 NICOLLET AVE. SO.
MINNEAPOLIS, MN55419
 Phone: 612-866-8550
 Fax: 612-866-9453
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for NICOLLET DENTAL

NPI Number 1003108895
LBN Legal business name NICOLLET DENTAL
Authorized official CASEY NELSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 05/11/2011
Last updated 05/11/2011 - About 15 years ago
Identifiers
MN License # D12104
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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