WEST SIDE COMMUNITY HEALTH SERVICES INC. NPI 1417007436

NPI Information

NPI: 1417007436
Provider Name: WEST SIDE COMMUNITY HEALTH SERVICES, INC.

Doing Business As: WEST SIDE DENTAL CLINIC

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
478 ROBERT ST S
SAINT PAUL, MN
ZIP 55107
Phone: (651) 602-7575
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WEST SIDE COMMUNITY HEALTH SERVICES, INC. is a dental clinic center in Saint Paul, MN. WEST SIDE COMMUNITY HEALTH SERVICES, INC. NPI is 1417007436. The provider is registered as an organization entity type.
The provider Is Doing Business As West Side Dental Clinic.

The provider's business location address is:

478 ROBERT ST S
SAINT PAUL, MN
ZIP 55107-236
Phone: (651) 602-7575
Fax: (651) 602-7518

The provider's authorized official is Mavis Carol Brehm .
The authorized official title is Executive Director and has the following contact phone number (651) 602-7536.

The enumeration date for this NPI number is 1/11/2007 and was last updated on 6/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QD0000X	Clinic/Center	Dental	302133	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	C00143	MEDICARE PIN	MINNESOTA
2	250711100	MEDICAID	MINNESOTA
3	241855	MEDICARE OSCAR/CERTIFICATION	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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