OrganizationActive
Family Periodontic Specialists, PLC
NPI 1194474593 · Periodontics · Saint Paul, MN
Provider details
- NPI number
- 1194474593
- Entity type
- Organization
- Primary specialty
- PeriodonticsDental Providers
- Parent organization
- Family Periodontic Specialists, PLC
- Organization subpart
- Yes
- Authorized official
- Celia Hayes, Credentialing Coordinator(217) 540-2100
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(60/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
4 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
1375 Saint Anthony Ave
Saint Paul, MN 55104-4006
Phone: (651) 645-4671
Fax: (651) 646-1342
Street-level locationGet directions
Mailing address
1375 Saint Anthony Ave
Saint Paul, MN 55104-4006
Other names (DBA / former)
- Doing business as
- Metro Dentalcare St. Paul Midway - Periodontics
Registry dates
- Enumerated
- 2022-03-22
- Last updated
- 2022-03-22
- Certified
- 2022-03-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.