OrganizationActive
Minneapolis-St. Paul Periodontics
NPI 1013216811 · Periodontics · Fridley, MN
Minneapolis-St. Paul Periodontics is a Periodontics organization in Fridley, MN (NPI 1013216811).
Provider details
- NPI number
- 1013216811
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Parent organization
- St. Croix Valley Dental
- Organization subpart
- Yes
- Authorized official
- Doug Wolff, Owner(651) 439-2600
- License
- D11710 (MN)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1109 East Moore Lake Drive
Fridley, MN 55432
Phone: (651) 439-2600
Fax: (651) 439-2211
Street-level locationGet directions
Mailing address
1109 East Moore Lake Drive
Fridley, MN 55432
Registry dates
- Enumerated
- 2011-03-18
- Last updated
- 2011-03-18
Frequently asked questions
- What is Minneapolis-St. Paul Periodontics's NPI number?
- Minneapolis-St. Paul Periodontics's National Provider Identifier (NPI) is 1013216811, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Minneapolis-St. Paul Periodontics?
- Minneapolis-St. Paul Periodontics is classified in the NPPES registry as Periodontics (Dental Providers).
- Where is Minneapolis-St. Paul Periodontics located?
- Minneapolis-St. Paul Periodontics's practice location on file with NPPES is 1109 East Moore Lake Drive, Fridley, MN 55432.
- What is Minneapolis-St. Paul Periodontics's phone number?
- The practice phone number listed in the NPPES registry for Minneapolis-St. Paul Periodontics is (651) 439-2600.
- Who is the authorized official for Minneapolis-St. Paul Periodontics?
- The authorized official listed on Minneapolis-St. Paul Periodontics's NPPES record is Doug Wolff, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Minneapolis-St. Paul Periodontics's NPI active?
- Yes — Minneapolis-St. Paul Periodontics's NPI (1013216811) is active in the NPPES registry as of the last update on 2011-03-18.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.