Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Birch Lake Dental PA

Organization General Practice Dentistry · NPI 1083853113

Birch Lake Dental PA provides General Practice Dentistry in White Bear Lake, Minnesota. Licensed in Minnesota. Registered with an NPI since 2009.

Licensed in
MN
In the registry since
2009
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2641 White Bear Pkwy
White Bear Lake, MN 55110 Not confirmed with CMS for 17 years — call before visiting
Phone: (651) 429-0404
Fax: (651) 429-0472
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence D10949MN (MN)
General Practice Dentistry Taxonomy 1223G0001X · Licence 7712MN (MN)

Record details

NPI number1083853113
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Geetha Damodaran — Owner · (651) 429-0404
NPI enumeratedFebruary 12, 2009
Last updated in NPPESFebruary 12, 2009
Mailing address2641 White Bear Parkway, White Bear Lake, MN 55110

Other providers in White Bear Lake