ENDODONTIC PROFESSIONALS PA PLYMOUTH ENDODONTICS (NPI# 1093908360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093908360 |
| Entity Type | Organization |
| Organization Name | ENDODONTIC PROFESSIONALS PA PLYMOUTH ENDODONTICS |
| Practice Address |
3401 Hwy 169 N Plymouth MN 55441 |
| Practice Telephone | 7635590859 |
| Practice Fax Number | 7635594356 |
| Mailing Telephone | 7635590859 |
| Mailing Fax Number | 7635594356 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |
| Authorized Official Name | THOMAS A KARN (VICE PRESIDENT) |
| Authorized Official Telephone | 7635594356 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | Y |
| Parent Organization Name | ENDODONTIC PROFESSIONALS PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
1093720 | MN | Dental Providers |
| Street Address |
3401 HWY 169 N |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1679787279 | Vinay Ravi | Radiology | 2955 Xenium Ln N Ste 40, Plymouth, MN 55441 | 2007-05-10 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285252874 | Plymouth Endodontics | Dentist | 9416 S Main St Ste 212, Plymouth, MI 48170-4148 | 2020-07-09 |
| 1083789572 | Brent Donald Rundquist | Dentist | 3401 Highway 169 North, Plymouth, MN 55441-2413 | 2006-11-21 |
| 1447323498 | Susan Gail Penniston | Dentist | 3401 Highway 169 N, Plymouth, MN 55441-2413 | 2006-11-16 |
| 1164506135 | Plymouth Dental Associates PC | Dentist | 42801 Schoolcraft Road, Plymouth, MI 48170 | 2006-10-25 |
| 1659607653 | Matthew Del Mastro | Dentist | 3401 Highway 169 N, Plymouth, MN 55441-2413 | 2009-10-26 |
| 1437318565 | Marco Donadio | Dentist | 110 Long Pond Rd, Plymouth, MA 02360-2642 | 2008-06-04 |
| 1356469787 | Steve J Vlahakis | Dentist | 9416 S Main St, Suite 212, Plymouth, MI 48170-4148 | 2007-03-26 |
| 1417075847 | Dennis Michael Gut | Dentist | 9416 S Main St, Suite 212, Plymouth, MI 48170-4148 | 2007-03-26 |
| 1578638946 | Thomas Andrew Karn | Dentist | 3401 Highway 169 N, Plymouth, MN 55441-2413 | 2006-11-21 |
| 1013082882 | Mark Richard Jensen | Dentist | 3401 Highway 169 N, Plymouth, MN 55441-2413 | 2006-11-21 |
| Find all providers in PLYMOUTH | ||||
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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.