MAIN STREET DENTAL (NPI# 1124150248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124150248 |
| Entity Type | Organization |
| Organization Name | MAIN STREET DENTAL |
| Practice Address |
301 Main St E Suite 2 New Prague MN 56071-1803 |
| Practice Telephone | 9527582376 |
| Practice Fax Number | 9527588708 |
| Mailing Telephone | 9527582376 |
| Mailing Fax Number | 9527588708 |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. PAULA JULIE NOVAK (OFFICE MANAGER) |
| Authorized Official Telephone | 9527582376 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124571369 | Main Street Dental | Dentist | 810 N Main Ave, Gresham, OR 97030-5538 | 2016-07-23 |
| 1699952440 | Main Street Dental | Clinic/Center | 340 W Main St, Carpentersville, IL 60110-2844 | 2008-01-23 |
| 1043557085 | Main Street Dental | Dentist | 8747 Northwest Dr, Southaven, MS 38671-2409 | 2013-01-10 |
| 1124359773 | Main Street Dental | Dentist | 207 Upper Main St, Edgartown, MA 02539-5927 | 2010-01-21 |
| 1649484098 | Main Street Dental | Dentist | 808 Main St, Westbrook, ME 04092-3423 | 2007-05-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MAIN STREET DENTAL | 810 N Main Ave, Gresham, OR 97030 |
| Oregon Corporations, Companies and Business Names | MAIN STREET DENTAL ASSISTING SCHOOL, LLC | 801 N Main Street, Gresham, OR 97030 |
| Oregon Corporations, Companies and Business Names | MAIN STREET DENTAL AT 1910 | 1910 Main Street Suite B, Forest Grove, OR 97116 |
| Oregon Corporations, Companies and Business Names | MAIN STREET DENTAL CARE | 116 S Main St Ste 1, Pendleton, OR 97801 |
| Colorado Business Entities | Main Street Dental Hygiene | 413 East Main Street, Buena Vista, CO 81211 |
| Indiana Business Entities | MAIN STREET DENTAL INVESTMENT, LLC | 9555 S. 475 East, Ferdinand, IN 47532-9466 |
| System for Award Management (SAM) Entities | MAIN STREET DENTAL OF LITTLETON, PLLC | 186 Main St, Littleton, NH 03561-4014 |
| Colorado Business Entities | Main Street Dental, LLC | 330 Main Street, Canyon City, CO 81212 |
| Iowa Business Entities | MAIN STREET DENTAL, P.C. | 1205 W. Main Street, Marshalltown, IA 50158 |
| Street Address |
301 MAIN ST E SUITE 2 |
| City | NEW PRAGUE |
| State | MN |
| Zip Code | 56071-1803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720034234 | John D Cervenka | Family Medicine | 301 Main St E, Suite 1, New Prague, MN 56071-1803 | 2006-05-26 |
| 1447424924 | Kristin E. Tiegs | Family Medicine | 301 Main St E, New Prague Medical Clinic, New Prague, MN 56071-1803 | 2008-04-16 |
| 1932220696 | Jon Paul Colling | Dentist | 301 Main St E, Suite 2, New Prague, MN 56071-1803 | 2007-04-02 |
| 1811018591 | George Winn | Dentist | 301 Main St E, Suite 2, New Prague, MN 56071-1803 | 2007-04-02 |
| 1841238078 | Jason M Becker | Emergency Medicine | 301 Main St E, Suite 1, New Prague, MN 56071-1803 | 2006-06-02 |
| 1649218876 | Steven J Kivi | Family Medicine | 301 Main St E, Suite 1, New Prague, MN 56071-1803 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154827087 | Jeremy Faus | Marriage & Family Therapist | 1405 East Main Street, Suite 2, New Prague, MN 56071 | 2018-03-31 |
| 1740537331 | Omega Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 125 West Main St, New Prague, MN 56071 | 2012-08-14 |
| 1811143936 | New Prague Dental Center | Dentist | 101 Lexington Ave S., New Prague, MN 56071 | 2008-08-08 |
| 1013083039 | Sharon L Bortscheller | Social Worker | 101 Lexington Ave South, New Prague, MN 56071 | 2006-11-28 |
| 1811082225 | Gregory Raymond Dvorak | Dentist | 136 W. Main St, New Prague, MN 56071 | 2006-10-03 |
| 1285728352 | Joel Gary Erickson | Chiropractor | 314 Main St E Suite 2, New Prague, MN 56071 | 2006-10-03 |
| 1124035282 | Mayo Clinic Health System-southwest Minnesota Region | General Acute Care Hospital | 301 2nd Street Ne, New Prague, MN 56071 | 2006-08-02 |
| 1780641209 | Jun Hong Liang | Family Medicine | 212 County Road 37, New Prague, MN 56071 | 2006-04-27 |
| 1275195737 | Mosaic Family Services, Ltd. | Counselor | 1405 East Main Street, New Prague, MN 56071 | 2019-07-05 |
| 1225396492 | Mary F Taylor | Dietitian, Registered | 301 2nd St Ne, New Prague, MN 56071 | 2012-04-25 |
| Find all providers in zip 56071 | ||||
| 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 |
|---|---|---|---|---|
| 1811143936 | New Prague Dental Center | Dentist | 101 Lexington Ave S., New Prague, MN 56071 | 2008-08-08 |
| 1811082225 | Gregory Raymond Dvorak | Dentist | 136 W. Main St, New Prague, MN 56071 | 2006-10-03 |
| 1649277385 | Kathleen J Garry | Dentist | 101 Lexington Ave S, New Prague, MN 56071-2423 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001149 | Kalyan Chakravarthy Kondreddi | Dentist | 327 Western Ave Ste A, Fergus Falls, MN 56537-2403 | 2020-10-20 |
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1770190951 | Bluff Creek Dental Pllc | Dentist | 600 Market St Ste 130, Chanhassen, MN 55317-4570 | 2020-09-30 |
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1073128153 | Michael W Flinn Dds, Pa | Dentist | 200 Firewood Drive, Redwood, MN 56283 | 2020-09-15 |
| 1770196891 | Thomas J Hoeffel Dds Pa | Dentist | 2819 Hamline Ave N Ste 104, Roseville, MN 55113-7718 | 2020-08-28 |
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 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 |
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| Find all providers with the same taxonomy | ||||
| City | NEW PRAGUE |
| Zip Code | 56071 |
Please comment or provide details below to improve the information on MAIN STREET DENTAL.
| 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.