MINNESOTA DENTAL PROFESSIONALS, P.C. (NPI# 1043715204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043715204 |
| Entity Type | Organization |
| Organization Name | MINNESOTA DENTAL PROFESSIONALS, P.C. |
| Other Organization Name | PILOT KNOB DENTAL CARE |
| Practice Address |
16138 Pilot Knob Rd Lakeville MN 55044 |
| Mailing Address |
16138 Pilot Knob Rd Lakeville MN 55044-4105 |
| Practice Telephone | 9526797779 |
| Practice Fax Number | 9526797778 |
| Mailing Telephone | 9526797779 |
| Mailing Fax Number | 9526797778 |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2018-06-05 |
| Authorized Official Name | JESSICA BRITT (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2175408426 |
| Is Organization Subpart | Y |
| Parent Organization Name | MINNESOTA DENTAL PROFESSIONALS, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | Dental Providers |
| Other Name | Type Code |
|---|---|
| Pilot Knob Dental Care | Doing Business As Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 16138 Pilot Knob Rd, Lakeville, MN 550444105 | 6123548875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451192 | Minnesota Dental Professionals, P.C. | Dentist | 107 12th St Sw Ste 2, Forest Lake, MN 55025-1467 | 2018-09-20 |
| 1447896733 | Minnesota Dental Professionals, P.C. | Dentist | 654 Central Ave E, Saint Michael, MN 55376-9632 | 2019-11-21 |
| 1154972909 | Minnesota Dental Professionals, P.C. | Dentist | 15243 Nowthen Blvd Nw, Ramsey, MN 55303-6138 | 2019-09-24 |
| 1245881093 | Minnesota Dental Professionals, P.C. | Dentist | 11237 Foley Blvd Nw, Coon Rapids, MN 55448-3389 | 2019-09-24 |
| 1225696925 | Minnesota Dental Professionals, P.C. | Dentist | 5901 94th Ave N Ste 105, Brooklyn Park, MN 55443-2389 | 2019-05-29 |
| 1073063103 | Minnesota Dental Professionals, P.C. | Dentist | 825 Nicollet Mall, Ste 425, Minneapolis, MN 55402-2606 | 2016-10-13 |
| Street Address |
16138 PILOT KNOB RD |
| City | LAKEVILLE |
| State | MN |
| Zip Code | 55044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518487263 | Katarina Klementina Foster | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044 | 2017-06-23 |
| 1306454871 | Tyler Rohr | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044-4105 | 2020-07-21 |
| 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 |
| 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 |
| 1649692864 | Orthodontic Care Specialists, Pllc | Dentist | 20143 Idealic Ave., Lakeville, MN 55044 | 2014-01-07 |
| Find all providers in zip 55044 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518451707 | Clint Matthew Kroeker | Dentist | 20143 Idealic Ave # 105, Lakeville, MN 55044-6343 | 2018-06-20 |
| 1518487263 | Katarina Klementina Foster | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044 | 2017-06-23 |
| 1598943441 | Jay D. Simonton | Dentist | 18572 Joplin Ave, Lakeville, MN 55044-4218 | 2008-02-02 |
| 1174693865 | Perri Ann Polman Larson | Dentist | 17599 Kenwood Trail W, Ste 7, Lakeville, MN 55044 | 2006-11-09 |
| 1891883260 | James Francis Lesch | Dentist | 20785 Holyoke Ave, Lakeville, MN 55044-9825 | 2006-10-11 |
| 1275634438 | Mackenzie King Platt | Dentist | 11183 205th St. W., Lakeville, MN 55044 | 2006-09-26 |
| 1316913411 | Metro Dentalcare, Plc | Dentist | 17597 Cedar Ave, Lakeville, MN 55044-5269 | 2006-02-27 |
| 1306454871 | Tyler Rohr | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044-4105 | 2020-07-21 |
| 1346807666 | Amanda Helgerson | Dentist | 16372 Kenrick Ave, Lakeville, MN 55044-3540 | 2019-05-22 |
| 1194101246 | Kimberly Denton Koch | Dentist | 17597 Cedar Ave, Lakeville, MN 55044-5269 | 2015-07-30 |
| Find all providers in LAKEVILLE | ||||
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| 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.