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

Nokomis Family Dental PA

Organization Dental Clinic/Center · NPI 1689284481

Nokomis Family Dental PA is a Dental Clinic/Center in Minneapolis, Minnesota. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4948 34th Ave S
Minneapolis, MN 55417-1504
Phone: (612) 722-4676
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X

Record details

NPI number1689284481
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Sam Jacobson — Business Manager · (952) 881-0504
NPI enumeratedAugust 6, 2020
Last updated in NPPESAugust 6, 2020
Certification dateAugust 6, 2020
Mailing address8910 Penn Ave S, Bloomington, MN 55431-2025

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