MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC – NPI #1144644717
Clinic/Center

MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC is an AHC clinic located in MAPLE GROVE, MN. NPPES has assigned the NPI number 1144644717 to MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC on February 18, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 6 years ago on Dec 19, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC below.

NPI Profile for
MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC

NPI Number
1144644717
Enumeration Date

(more than 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MAPLE GROVE CENTER FOR RESTORATIVE SURGERY LLC
Primary location
13601 80TH CIRCLE NORTH
SUITE 100
MAPLE GROVE, MN 55369
Phone: (763) 432-7655 Fax: (763) 432-7501
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DANIEL HANSON
MEDICAL DIRECTOR
Phone: (651) 324-8693
Updated
Certification Date
Dec 19, 2019

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)
MN 679516700023

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.