MEDICARE: ONYX DENTAL, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1699601310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONYX DENTAL, PLLC

Provider Business Mailing Address
First Line	:	2232 HENNEPIN AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2737
Country	:	US
Telephone Number	:	612-281-6866
Fax Number	:

Provider Business Practice Location Address
First Line	:	2232 HENNEPIN AVE
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-2737
Country	:	US
Telephone Number	:	612-749-3314
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SIYAD ABDULLAHI
Credential	:
Telephone Number	:	612-281-6866

Provider Enumeration Date	:	06/22/2026
Last Update Date	:	06/22/2026

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