OrganizationActive
Custom Smiles Dentistry, PLLC
NPI 1528678497 · Dental Clinic/Center · Andover, MN
Custom Smiles Dentistry, PLLC is a Dental Clinic/Center organization in Andover, MN (NPI 1528678497).
Provider details
- NPI number
- 1528678497
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Pao Chua Vang, Dentist(763) 390-8995
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 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
2258 Bunker Lake Blvd Nw
Andover, MN 55304-3900
Phone: (763) 390-8995
Fax: (763) 390-8999
Street-level locationGet directions
Mailing address
2258 Bunker Lake Blvd Nw
Andover, MN 55304-3900
Other names (DBA / former)
- Doing business as
- Custom Smiles Dentistry
Registry dates
- Enumerated
- 2020-08-05
- Last updated
- 2020-08-05
- Certified
- 2020-08-05
Frequently asked questions
- What is Custom Smiles Dentistry, PLLC's NPI number?
- Custom Smiles Dentistry, PLLC's National Provider Identifier (NPI) is 1528678497, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Custom Smiles Dentistry, PLLC?
- Custom Smiles Dentistry, PLLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is Custom Smiles Dentistry, PLLC located?
- Custom Smiles Dentistry, PLLC's practice location on file with NPPES is 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900.
- What is Custom Smiles Dentistry, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Custom Smiles Dentistry, PLLC is (763) 390-8995.
- Who is the authorized official for Custom Smiles Dentistry, PLLC?
- The authorized official listed on Custom Smiles Dentistry, PLLC's NPPES record is Pao Chua Vang, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Custom Smiles Dentistry, PLLC's NPI active?
- Yes — Custom Smiles Dentistry, PLLC's NPI (1528678497) is active in the NPPES registry as of the last update on 2020-08-05.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.