OrganizationActive
Great Lakes Endodontics
NPI 1104255371 · Dental Clinic/Center · Hermantown, MN
Great Lakes Endodontics is a Dental Clinic/Center organization in Hermantown, MN (NPI 1104255371).
Provider details
- NPI number
- 1104255371
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Mark Phillips, Dentist(651) 528-0240
- License
- D12534 (MN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(77/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 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
4815 W Arrowhead Rd
Hermantown, MN 55811-4004
Phone: (218) 772-0772
Street-level locationGet directions
Mailing address
4815 W Arrowhead Rd
Hermantown, MN 55811-4004
Registry dates
- Enumerated
- 2013-11-07
- Last updated
- 2013-11-07
Frequently asked questions
- What is Great Lakes Endodontics's NPI number?
- Great Lakes Endodontics's National Provider Identifier (NPI) is 1104255371, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Great Lakes Endodontics?
- Great Lakes Endodontics is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Great Lakes Endodontics located?
- Great Lakes Endodontics's practice location on file with NPPES is 4815 W Arrowhead Rd, Hermantown, MN 55811-4004.
- What is Great Lakes Endodontics's phone number?
- The practice phone number listed in the NPPES registry for Great Lakes Endodontics is (218) 772-0772.
- Who is the authorized official for Great Lakes Endodontics?
- The authorized official listed on Great Lakes Endodontics's NPPES record is Mark Phillips, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Great Lakes Endodontics's NPI active?
- Yes — Great Lakes Endodontics's NPI (1104255371) is active in the NPPES registry as of the last update on 2013-11-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.