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

Northdale Dentist PA

Organization General Practice Dentistry · NPI 1619287562

Northdale Dentist PA provides General Practice Dentistry in Coon Rapids, Minnesota. Licensed in Minnesota. Registered with an NPI since 2010.

Licensed in
MN
In the registry since
2010
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

2147 Northdale Blvd NW
Coon Rapids, MN 55433 Not confirmed with CMS for 15 years — call before visiting
Phone: (763) 497-6977
Fax: (763) 463-7807
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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 D12003 (MN)

Record details

NPI number1619287562
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jagannatian Ramakrishnan — Dentist · (763) 218-2887
NPI enumeratedOctober 13, 2010
Last updated in NPPESOctober 13, 2010
Mailing address6808, 67th Street Ne., Albertville, MN 55301

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