IndividualActive
Corey Vang
NPI 1619724903 · General Practice Dentistry · Crystal, MN
Provider details
- NPI number
- 1619724903
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Sex
- Male
- Sole proprietor
- No
- License
- $$$$$$$$$ (MN)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 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
5700 Bottineau Blvd Ste 270
Crystal, MN 55429-2671
Phone: (763) 200-8952
Approximate (ZIP-level) locationGet directions
Mailing address
12871 Flamingo St Nw
Coon Rapids, MN 55448-1538
Registry dates
- Enumerated
- 2024-05-03
- Last updated
- 2024-05-06
- Certified
- 2024-05-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.