Healthcare Provider Details

I. General information

NPI: 1023801578
Provider Name (Legal Business Name): FILIPA MIRANDA DOS SANTOS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2025
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5851 DULUTH ST
GOLDEN VALLEY MN
55422-3946
US

IV. Provider business mailing address

5851 DULUTH ST
GOLDEN VALLEY MN
55422-3946
US

V. Phone/Fax

Practice location:
  • Phone: 763-546-1301
  • Fax:
Mailing address:
  • Phone: 763-546-1301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD15515
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: