Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Family Orthodontic Specialists PLC

Organization Orthodontics and Dentofacial Orthopedics Dentistry · NPI 1104569839

Family Orthodontic Specialists PLC is an Orthodontics and Dentofacial Orthopedics Dentistry in St Louis Park, Minnesota. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

4959 Excelsior Blvd Ste 200
St Louis Park, MN 55416-3003
Phone: (952) 920-8774
Fax: (952) 920-8979
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthodontics and Dentofacial Orthopedics Dentistry (primary) Taxonomy 1223X0400X

Record details

NPI number1104569839
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationFamily Orthodontic Specialists PLC
Authorized official Celia Hayes — Credentialing Coordinator · (217) 540-2100
Other names Woodlake Orthodontics St Louis Park
NPI enumeratedApril 20, 2022
Last updated in NPPESApril 20, 2022
Certification dateApril 20, 2022
Mailing address4959 Excelsior Blvd Ste 200, St Louis Park, MN 55416-3003

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