Unknown Individual – General Practice Dentistry, NPI 1780660100

Unknown Individual is a healthcare provider. based in Edina, Minnesota. specializing in General Practice Dentistry. They hold a License No. 7552 (MN). The NPI Number for Unknown Individual is 1780660100

Main info

Organization
Inactive
Name
Unknown Individual
NPI
1780660100
Phone
(952) 920-0800
Address
4010 W 65TH ST
Deactivation Date
8 January 2026
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4010, West 65th Street, Southdale, Edina, Hennepin County, Minnesota, 55435, United States

    #205

    EDINA, MN 554351721

    Phone: (952) 920-0800

    Fax: (952) 915-6463

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55435)

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Reviews

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Frequently asked questions

How do payers reference Unknown Individual?
For Unknown Individual, use NPI 1780660100 as the unique 10-digit identifier.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What kind of doctor is Unknown Individual?
Unknown Individual is associated with General Practice Dentistry in the directory — Clinical services aligned with this taxonomy classification.
Where in Minnesota is Unknown Individual registered?
Use Edina, Minnesota as the headline location for Unknown Individual here.
When was this NPI issued?
Enumeration for Unknown Individual is noted as not shown in this record where the registry provides it.

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