WEST RIVER DENTAL CARE (NPI# 1033223581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033223581 |
| Entity Type | Organization |
| Organization Name | WEST RIVER DENTAL CARE |
| Practice Address |
4103 E Lake St Minneapolis MN 55406-2259 |
| Practice Telephone | 6127212424 |
| Practice Fax Number | 6127213054 |
| Mailing Telephone | 6127212424 |
| Mailing Fax Number | 6127213054 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL PAUL SKADRON (OWNER) |
| Authorized Official Telephone | 6127212424 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
10636 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS PROVIDER # | 7B839SK | 01 |
| Street Address |
4103 E LAKE ST |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55406-2259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932576238 | Heritage Transportation, Inc. | Non-emergency Medical Transport (VAN) | 4103 E Lake St, Minneapolis, MN 55406-2259 | 2015-08-21 |
| 1285714436 | Michael P Skadron | Dentist | 4103 E Lake St, Minneapolis, MN 55406-2259 | 2006-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286221 | Hoa Bui | Pharmacist | 4547 Hiawatha, Minneapolis, MN 55406 | 2020-08-17 |
| 1184263253 | Carrie Shannon Nightshade | Acupuncturist | 3706 E 42nd Street, Minneapolis, MN 55406 | 2020-01-06 |
| 1164060059 | Deborah Owen | Acupuncturist | 3706 E 42nd St, Minneapolis, MN 55406 | 2019-12-11 |
| 1194290593 | Noelle Therese Wolf | Counselor | 2637 27th Ave S # 229, Minneapolis, MN 55406 | 2018-10-11 |
| 1255819819 | Ayan Osman Ali | Behavior Technician | 3355 Haiwatha Ave Suite 100, Minneapolis, MN 55406 | 2018-08-04 |
| 1881188597 | Lydia Joy Allison | Massage Therapist | 2933 29th Ave. S., Minneapolis, MN 55406 | 2018-06-15 |
| 1497261770 | Carroll Lee Beaty | Massage Therapist | 2801 42nd Ave. So., Minneapolis, MN 55406 | 2017-12-21 |
| 1578082798 | Capitol Cafe LLC | Home Delivered Meals | 2417 E Franklin Ave, Capitol Cafe, Minneapolis, MN 55406 | 2017-09-19 |
| 1851823942 | Safia Abdulkadir Mohamud | Contractor | 2740 Minnehaha Ave Suit 100, Minneapolis, MN 55406 | 2017-03-29 |
| 1881051944 | Sos Transportation LLC | Non-emergency Medical Transport (VAN) | 3355 Haiwatha Ave Suit 100, Minneapolis, MN 55406 | 2016-01-20 |
| Find all providers in zip 55406 | ||||
| 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 |
|---|---|---|---|---|
| 1679182687 | Downtown Dental Center Pllc | Dentist | 825 Nicollet Mall Ste 1427, Minneapolis, MN 55402-2703 | 2020-07-26 |
| 1205444791 | Patrick Reilly Steck | Dentist | 4948 S 34th Ave, Minneapolis, MN 55417 | 2020-07-21 |
| 1124684725 | Eric James Holthaus | Dentist | 825 Nicollet Ave #1025, Minneapolis, MN 55402 | 2019-05-20 |
| 1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
| 1154828283 | Ari Michael Lederman | Dentist | 825 Nicollet Mall Ste 425, Minneapolis, MN 55402-2608 | 2018-04-05 |
| 1730604877 | Daryl Grigsby Jr. | Dentist | 515 Delaware St Se # 8-166, Minneapolis, MN 55455-0357 | 2017-08-10 |
| 1033630371 | Margaret Elizabeth Craven | Dentist | 250 2nd Ave S Ste 250, Minneapolis, MN 55401-2173 | 2017-06-27 |
| 1013330661 | Helen Oboro-onuora | Dentist | 606 24th Ave S Suite 200, Umphysicians Dental Clinic, Minneapolis, MN 55454 | 2014-01-31 |
| 1548690001 | Patrick J. Foy Dds,pa | Dentist | 606 24th Ave S Ste 806, Minneapolis, MN 55454-1438 | 2013-11-20 |
| 1659719078 | Deanna Miller | Dentist | 3428 20th Ave S, Minneapolis, MN 55407-2408 | 2013-06-07 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55406 |
Please comment or provide details below to improve the information on WEST RIVER DENTAL CARE.
| 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.