Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Maple Grove Family Dental Clinic, PA

General Practice Dentistry in Maple Grove, MN · enumerated 2006 · authorized official Susan Larson, Clinic Administrator.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1922181197

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Registry record

Entity type Organization (Type 2)

Legal business name Maple Grove Family Dental Clinic, PA

Practice address 12000 Elm Creek Blvd N, Suite #220, Maple Grove, MN, 55369

Phone (763) 420-4421

Fax (763) 420-5674

Enumeration date Oct 23, 2006

Last updated in NPPES Aug 22, 2020

Taxonomy & classification

1223G0001X General Practice Dentistry Dental Providers · License 9790 (MN) Secondary

1223G0001X General Practice Dentistry Dental Providers · License 10067 (MN) Secondary

1223G0001X General Practice Dentistry Dental Providers · License D11341 (MN) Primary

Authorized official

Name Susan Larson

Title Clinic Administrator

Phone (763) 420-4421

Other identifiers

Identifier	Type	State	Issuer
10656	Other	MN	BLUECROSSBLUE SHIELD

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2020-08-22. Verify at npiregistry.cms.hhs.gov.

Where is Maple Grove Family Dental Clinic, PA located?

The practice location on file with NPPES is in Maple Grove, MN.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-08-22.