OrganizationActive
Birch Lake Dental
NPI 1922619162 · Dental Clinic/Center · White Bear Lake, MN
Provider details
- NPI number
- 1922619162
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Geetha Damodaran, Owner(651) 429-0404
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
4641 White Bear Pkwy
White Bear Lake, MN 55110-3300
Phone: (651) 429-0404
Street-level locationGet directions
Mailing address
4641 White Bear Pkwy
White Bear Lake, MN 55110-3300
Other names (DBA / former)
- Doing business as
- Birch Lake Dental
Registry dates
- Enumerated
- 2020-08-12
- Last updated
- 2020-08-12
- Certified
- 2020-08-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.