ORTHODONTIC SPECIALISTS OF MINNESOTA, PLLC (NPI# 1013517093) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013517093 |
| Entity Type | Organization |
| Organization Name | ORTHODONTIC SPECIALISTS OF MINNESOTA, PLLC |
| Practice Address |
10150 City Walk Dr Apt C Woodbury MN 55129-9270 |
| Mailing Address |
2200 County Road C W Ste 2210 Roseville MN 55113-2551 |
| Practice Telephone | 6512682992 |
| Mailing Telephone | 6517462815 |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | SHANNON HESSE (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 6517462815 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| The Dental Specialist Orthodontics Woodbury | Doing Business As Name - Organization |
| Street Address |
10150 CITY WALK DR APT C |
| City | WOODBURY |
| State | MN |
| Zip Code | 55129-9270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407948060 | Kristy Lynn Petersen | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2006-09-29 |
| 1902235245 | Dental Specialists of Minnesota, Pllc | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2013-11-07 |
| 1184716755 | Lori Marie Gmeinder | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770006983 | Logan Thompson | Chiropractor | 10631 Pond Curve, Woodbury, MN 55129 | 2017-07-19 |
| 1942650619 | The Hendricks Group Inc. | Assisted Living Facility | 10025 Antrim Court, Woodbury, MN 55129 | 2016-06-14 |
| 1235588468 | Nathan Robert Mayernik | Physical Therapist | 4123 Radio Dr, Suite 100, Woodbury, MN 55129 | 2016-06-08 |
| 1699146035 | St. Therese of Woodbury, LLC | Skilled Nursing Facility | 7555 Bailey Road, Woodbury, MN 55129 | 2015-10-12 |
| 1548602865 | Monica Bajracharya | Internal Medicine | 9373 Compass Pointe Rd, Woodbury, MN 55129 | 2013-07-28 |
| 1730454752 | Amanda E Feeney | Physical Therapist | 4123 Radio Drive, Ste 100, Woodbury, MN 55129 | 2012-03-09 |
| 1104193762 | Minneapolis-st.paul Endodontics | Dentist | 10150 City Walk Dr Ste C, Woodbury, MN 55129 | 2011-11-28 |
| 1659502417 | Charles Goff Jr. | Marriage & Family Therapist | 1919 University Ave W Suite 200, St. Paul, MN 55129 | 2009-07-28 |
| 1497821391 | Kyle Riley Edlund | Dentist | 3060 Woodbury Drive, #b, Woodbury, MN 55129 | 2006-11-24 |
| 1902979206 | Robert Edgar Eng | Dentist | 3100 Woodbury Drive, Woodbury, MN 55129 | 2006-11-16 |
| Find all providers in zip 55129 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952538399 | Mita Amrish Parikh | Dentist | 136 Woodbury Rd Ste 102, Woodbury, NY 11797-1411 | 2009-06-11 |
| 1023169265 | Curtis Roy Dunn | Dentist | 783 Radio Dr, Suite 107, Woodbury, MN 55125-9454 | 2007-01-15 |
| 1528128436 | Steven John Henseler | Dentist | 1000 Radio Dr Ste 220, Woodbury, MN 55125-8444 | 2006-12-11 |
| 1902979206 | Robert Edgar Eng | Dentist | 3100 Woodbury Drive, Woodbury, MN 55129 | 2006-11-16 |
| 1770503799 | Gady Ross Segal | Dentist | 142 Emerson St # B, Woodbury, NJ 08096-3235 | 2006-07-20 |
| 1578505152 | Minnesota Orthodontics | Dentist | 3100 Woodbury Dr, Woodbury, MN 55129-9600 | 2006-06-11 |
| 1972097467 | Ryan Lubinsky | Dentist | 3100 Woodbury Dr, Woodbury, MN 55129-9600 | 2018-06-18 |
| 1669972063 | Sletten & Brettin Orthodontics | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125-4884 | 2018-02-13 |
| 1407309784 | Henseler Orthodontics | Dentist | 1000 Radio Dr, Suite 220, Woodbury, MN 55125-8409 | 2016-08-03 |
| 1679937387 | Woobury Pediatric Dentistry and Orthodontics | Dentist | 800 Woodbury Rd, Suite E, Woodbury, NY 11797-2503 | 2016-04-08 |
| Find all providers in WOODBURY | ||||
Please comment or provide details below to improve the information on ORTHODONTIC SPECIALISTS OF MINNESOTA, PLLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.