Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Long Lake Family Denistry

Organization General Practice Dentistry · NPI 1134574163

Long Lake Family Denistry provides General Practice Dentistry in New Brighton, Minnesota. Licensed in Minnesota. Registered with an NPI since 2016.

Licensed in
MN
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

991 9th Ave NW
New Brighton, MN 55112-2665 Not confirmed with CMS for 10 years — call before visiting
Phone: (651) 633-1311
Fax: (651) 633-4339
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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 10256 (MN)
General Practice Dentistry Taxonomy 1223G0001X · Licence D13480 (MN)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 10465 (MN)

Record details

NPI number1134574163
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Hossein Jalali — Owner · (651) 633-1311
NPI enumeratedApril 27, 2016
Last updated in NPPESApril 27, 2016
Mailing address991 9th Ave Nw, New Brighton, MN 55112-2665

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