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

Family Periodontic Specialists, PLC

Organization Periodontics · NPI 1194474593

Family Periodontic Specialists, PLC is a Periodontics in Saint Paul, Minnesota. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

1375 Saint Anthony Ave
Saint Paul, MN 55104-4006
Phone: (651) 645-4671
Fax: (651) 646-1342
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Periodontics (primary) Taxonomy 1223P0300X

Record details

NPI number1194474593
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationFamily Periodontic Specialists, PLC
Authorized official Celia Hayes — Credentialing Coordinator · (217) 540-2100
Other names Metro Dentalcare St. Paul Midway - Periodontics
NPI enumeratedMarch 22, 2022
Last updated in NPPESMarch 22, 2022
Certification dateMarch 22, 2022
Mailing address1375 Saint Anthony Ave, Saint Paul, MN 55104-4006

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