DR. MYRON A HENRICKSON (NPI# 1023231776) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023231776 |
| Entity Type | Individual |
| Full Name | DR. MYRON A HENRICKSON |
| Credential | DDS |
| Practice Address |
17436 Kenwood Trl Lakeville MN 55044 |
| Mailing Address |
2200 County Road C W Ste 2210 Roseville MN 55113-2551 |
| Practice Telephone | 9522415899 |
| Practice Fax Number | 9522415897 |
| Mailing Telephone | 9522415899 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2018-07-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D9492 | MN | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 17436 Kenwood Trl, Lakeville, MN 550449219 | 9522415899 |
| Street Address |
17436 KENWOOD TRL |
| City | LAKEVILLE |
| State | MN |
| Zip Code | 55044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205265535 | Pdg, P.a. | Clinic/Center | 17436 Kenwood Trl, Lakeville, MN 55044-9219 | 2013-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518528397 | Fairview Pharmacy Services LLC | Non-Pharmacy Dispensing Site | Fairview Lakeville Clinic Mtm, 18580 Joplin Ave, Lakeville, MN 55044 | 2019-06-24 |
| 1164922373 | Invigorate Chiropractic, Pa | Chiropractor | 18449 Orchard Trail, Lakeville, MN 55044 | 2018-02-14 |
| 1275046344 | Kevin Schultz | Chiropractor | 18449 Orchard Tr, Lakeville, MN 55044 | 2017-11-13 |
| 1518487263 | Katarina Klementina Foster | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044 | 2017-06-23 |
| 1275069676 | Alison Marie Weaver | Physical Therapist | 17599 Kenwood Trl Ste 200, Lakeville, MN 55044 | 2017-05-04 |
| 1184177479 | Megan Erickson | Physical Therapist | 21034 Heron Way Ste 102, Lakeville, MN 55044 | 2016-08-03 |
| 1669827523 | Kristine Louise Duhamel | Nurse Practitioner | 18275 Kenrick Avenue, Lakeville, MN 55044 | 2016-04-28 |
| 1003281536 | Heather Leann Wegner | Counselor | 16233 Kenyon Ave, Lakeville, MN 55044 | 2015-12-09 |
| 1982081295 | Dana Bungert | Specialist/Technologist | 11060 Upper 167th St W, Lakeville, MN 55044 | 2015-05-06 |
| 1265834931 | Kayla Schulz | Counselor | 7535 165th St West, Lakeville, MN 55044 | 2014-09-24 |
| Find all providers in zip 55044 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053840058 | Christa Colleen Coscia | Dentist | 54 Main St Ste 6, Lakeville, MA 02347-3622 | 2017-06-05 |
| 1386031664 | Brenda Flores Sousa | Dentist | 6003 Big Tree Rd., Lakeville, NY 14480 | 2015-04-23 |
| 1245525880 | Jeffery Arthur Kohler Jr. | Dentist | 17600 Cedar Ave, Lakeville, MN 55044-6339 | 2011-06-11 |
| 1881849636 | Lake Marion Dental Care | Dentist | 19950 Dodd Blvd, Lakeville, MN 55044-6341 | 2008-11-20 |
| 1053538579 | Henry David Watzl | Dentist | 9202 202nd St W Ste 201, Lakeville, MN 55044-7917 | 2007-04-18 |
| 1841365293 | Robert B. Miller | Dentist | 17746 Kenwood Trl, Lakeville, MN 55044-9454 | 2006-11-21 |
| 1043395809 | Ghassan A Khoury | Dentist | 12 Colleen Dr, Lakeville, MA 02347-1663 | 2006-10-27 |
| 1144329814 | Peter John Regas | Dentist | 69 Main St., Lakeville, MA 02347-1618 | 2006-09-21 |
| 1700998929 | Jennifer Elizabeth Harrison | Dentist | 20171 Icenic Trl, Lakeville, MN 55044-7708 | 2006-09-01 |
| 1255442620 | Lakeville Family Dental Centre Pa | Dentist | 16375 Kenrick Ave Ste 200, Lakeville, MN 55044-8494 | 2006-08-31 |
| Find all providers in LAKEVILLE | ||||
Please comment or provide details below to improve the information on DR. MYRON A HENRICKSON.
| 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.