Healthcare Provider Details

I. General information

NPI: 1497678643
Provider Name (Legal Business Name): DIGITAL DENTAL SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 WASHINGTON AVE N STE 202
MINNEAPOLIS MN
55401-1148
US

IV. Provider business mailing address

800 WASHINGTON AVE N STE 202
MINNEAPOLIS MN
55401-1148
US

V. Phone/Fax

Practice location:
  • Phone: 952-212-0168
  • Fax:
Mailing address:
  • Phone: 952-212-0168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA BLENDERMANN PERONE
Title or Position: PARTNER
Credential: DDS
Phone: 952-212-0168