MINNESOTA DENTAL SURGERY PLLC (NPI# 1124478607) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124478607 |
| Entity Type | Organization |
| Organization Name | MINNESOTA DENTAL SURGERY PLLC |
| Practice Address |
9801 Dupont Ave S Bloomington MN 55431-3100 |
| Mailing Address |
3510 120th St W Rosemount MN 55068-3501 |
| Practice Telephone | 9522157419 |
| Mailing Telephone | 9522157419 |
| Enumeration Date | 2016-06-15 |
| Last Update Date | 2016-06-15 |
| Authorized Official Name | DR. BENNETT ISABELLA (CEO) |
| Authorized Official Telephone | 9522157419 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D12540 | MN | Ambulatory Health Care Facilities |
| Street Address |
9801 DUPONT AVE S |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55431-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134114259 | Elizabeth A Davis | Ophthalmology | 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 | 2005-09-14 |
| 1205249620 | Mark Buboltz | Optometrist | 9801 Dupont Ave S, Suite 200, Bloomington, MN 55431-3100 | 2014-06-03 |
| 1407109275 | Kasie Jean Mix | Optometrist | 9801 Dupont Ave S, Ste 200, Bloomington, MN 55431-3100 | 2012-10-18 |
| 1295097277 | Katherine Ann Montealegre | Optometrist | 9801 Dupont Ave S, Suite 425, Bloomington, MN 55431-3100 | 2012-06-14 |
| 1134416605 | Thomas L Elton | Optometrist | 9801 Dupont Ave S, Suite 425, Bloomington, MN 55431-3100 | 2011-07-06 |
| 1093037772 | Laura Gundale | Physician Assistant | 9801 Dupont Ave S, 425, Bloomington, MN 55431-3100 | 2010-02-22 |
| 1467787226 | Mark Spencer Hansen | Ophthalmology | 9801 Dupont Ave S, 425, Bloomington, MN 55431-3100 | 2009-10-13 |
| 1548499676 | Tara Rae Barth | Optometrist | 9801 Dupont Ave S, Ste 200, Bloomington, MN 55431-3100 | 2009-07-10 |
| 1457508988 | Noumia Cloutier-gill | Optometrist | 9801 Dupont Ave S, Suite 425, Bloomington, MN 55431-3100 | 2008-08-27 |
| 1629230206 | Christine Leeann Larsen | Ophthalmology | 9801 Dupont Ave S, Bloomington, MN 55431-3100 | 2008-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
| 1760042253 | Adams Health Care Services, LLC | Registered Nurse | 10036 Washburn Ave S, Bloomington, MN 55431 | 2019-06-17 |
| 1851864755 | Hope Autism Center | Day Training, Developmentally Disabled Services | 9333 Penn Ave S, Bloomington, MN 55431 | 2019-01-03 |
| 1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
| 1497240469 | Mikayla Slegh | Behavior Technician | 8200 Humboldt Ave S Suite 100, Bloomington, MN 55431 | 2018-06-22 |
| 1073061552 | David Wells | Nurse Practitioner | 8100 Northland Dr., Bloomington, MN 55431 | 2016-09-14 |
| 1780033076 | Yasin Jama | Contractor | 9810 Drew Avenue South, Apartment 106, Bloomington, MN 55431 | 2016-06-07 |
| 1972961001 | Kadar Hadis | Social Worker | 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431 | 2016-02-03 |
| 1063878908 | Amazing Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 9031 Penn Ave South Suite 100, Bloomington, MN 55431 | 2016-01-07 |
| 1093170136 | Kelsey Margaret Perreault | Chiropractor | 8120 Penn Ave. S., Suite 525, Bloomington, MN 55431 | 2015-12-16 |
| Find all providers in zip 55431 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073904470 | Nick Weiss Dds LLC | Clinic/Center | 2801 E Carowinds Ct, Bloomington, IN 47401-9716 | 2015-02-07 |
| 1114050432 | Mitchell Olson, Dds Pa | Clinic/Center | 8400 Lyndale Ave S Ste 8, Bloomington, MN 55420-2790 | 2007-03-14 |
| 1063011666 | David A. Engan, Dds | Clinic/Center | 9848 Lyndale Ave S, Bloomington, MN 55420-4731 | 2020-10-23 |
| 1154971380 | Gentle Dentistry of Bloomington Pllc | Clinic/Center | 10611 France Ave S Ste 201, Bloomington, MN 55431-3554 | 2019-09-19 |
| 1962059907 | Finney Dental LLC | Clinic/Center | 2909 E Buick Cadillac Blvd, Bloomington, IN 47401-5443 | 2019-08-23 |
| 1497218184 | Action Dental | Clinic/Center | 10584 France Ave S, Bloomington, MN 55431-3538 | 2019-04-09 |
| 1013402981 | Morgan-michaels Family Dentistry, LLC | Clinic/Center | 2306 Stern Dr, Bloomington, IL 61704 | 2018-06-24 |
| 1780187674 | Martin T Barco, D.d.s., P.C. | Clinic/Center | 615 N Walnut St, Bloomington, IN 47404-3811 | 2018-03-16 |
| 1396267423 | H&b II LLC | Clinic/Center | 409 S Dunn St, Bloomington, IN 47401-4822 | 2017-07-11 |
| 1770965717 | Gentle Dental | Clinic/Center | 3929 E 3rd St, Bloomington, IN 47401-5554 | 2015-06-26 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55431 |
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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.