OrganizationActive
Hanover Dental PLLC
NPI 1487147260 · Dental Clinic/Center · Hanover, MN
Provider details
- NPI number
- 1487147260
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Tyler Koivisto, Dentist(763) 226-7379
- License
- D13236 (MN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 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
411 Labeaux Ave Ne
Hanover, MN 55341
Phone: (763) 400-3005
Street-level locationGet directions
Mailing address
1192 Bice Ave Nw
Buffalo, MN 55313-4456
Other names (DBA / former)
- Doing business as
- Hanover Dental
- Doing business as
- Hanover Dental
Registry dates
- Enumerated
- 2018-06-07
- Last updated
- 2018-06-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.