MODERN DENTAL PROFESSIONALS, MN PC (NPI# 1144513565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144513565 |
| Entity Type | Organization |
| Organization Name | MODERN DENTAL PROFESSIONALS, MN PC |
| Other Organization Name | MIDWEST DENTAL |
| Practice Address |
507 S Shore Dr Worthington MN 56187-1400 |
| Practice Telephone | 5073722072 |
| Practice Fax Number | 5073722362 |
| Mailing Telephone | 5073722072 |
| Mailing Fax Number | 5073722362 |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |
| Authorized Official Name | DR. JEFFREY W MOOS (CEO) |
| Authorized Official Telephone | 7159265050 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Midwest Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770939613 | Modern Dental Professionals, Mn PC | Dentist | 20700 Chippendale Ave W, Suite 10, Farmington, MN 55024-8207 | 2016-05-10 |
| 1710357520 | Modern Dental Professionals, Mn PC | Dentist | 1625 Lena Ct, Suite 100, Eagan, MN 55122-2959 | 2015-10-06 |
| 1003286808 | Modern Dental Professionals, Mn PC | Dentist | 2147 Northdale Blvd Nw, Nwood, Coon Rapids, MN 55433-3006 | 2015-10-06 |
| 1710358379 | Modern Dental Professionals, Mn PC | Dentist | 7532 Brooklyn Blvd, Brooklyn Park, MN 55443-3101 | 2015-10-08 |
| 1881060069 | Modern Dental Professionals, Mn PC | Dentist | 3909 Silver Lake Rd Ne, Minneapolis, MN 55421-4352 | 2015-08-11 |
| 1558643817 | Modern Dental Professionals, Mn PC | Dentist | 4140 Thielman Ln, Suite 302, Saint Cloud, MN 56301-7326 | 2011-09-13 |
| 1679853451 | Modern Dental Professionals, Mn PC | Dentist | 107 Dupont Ave Nw, Renville, MN 56284 | 2011-08-24 |
| 1295965572 | Modern Dental Professionals, Mn PC | Dentist | 379 S Main St, Zumbrota, MN 55992-1543 | 2009-07-21 |
| 1073796744 | Modern Dental Professionals, Mn PC | Dentist | 560 Debra Dr, Lewiston, MN 55952-2104 | 2007-12-17 |
| 1124159983 | Modern Dental Professionals, Mn PC | Dentist | 680 Hehli Way, Mondovi, WI 54755-1639 | 2007-03-07 |
| Street Address |
507 S SHORE DR |
| City | WORTHINGTON |
| State | MN |
| Zip Code | 56187-1400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316224363 | Paul Michael Carlson | Dentist | 507 South Shore Drive, Worthington, MN 56187 | 2011-11-04 |
| 1912216540 | Nobles County Jail | Clinic/Center | 1530 Airport Road, Worthington, MN 56187 | 2010-09-30 |
| 1306984539 | Edward Thomas Mcniece | Dentist | 1027 Second Ave, Worthington, MN 56187 | 2007-02-01 |
| 1053338780 | Diagnostic Radiologic Imaging Pa | Radiology | 1607 N Mcmillan St, Ste 1, Worthington, MN 56187 | 2006-07-17 |
| 1427014232 | Scott James Hoffman | Podiatrist | 1205 Ryans Road, Worthington, MN 56187 | 2006-04-21 |
| 1588654404 | Jason Coy Turner | Pharmacist | 511 10th St, Worthington, MN 56187 | 2005-10-22 |
| 1518433879 | Nicole Block | Nurse Practitioner | 1680 Diagonal Rd, Worthington, MN 56187 | 2018-10-15 |
| 1033423322 | Rachael R Dekker | Nurse Practitioner | 1018 6th Ave, Worthington, MN 56187 | 2010-07-29 |
| 1417196601 | Jonathan Gabriel Eli-phillips | Obstetrics & Gynecology | 1018 6th Ave, Worthington, MN 56187 | 2009-02-11 |
| 1174716245 | Sanford Clinic | Radiology | 1018 6th Ave, Worthington, MN 56187 | 2007-08-22 |
| Find all providers in zip 56187 | ||||
| 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 |
|---|---|---|---|---|
| 1801362538 | Dr Rajan K Sheth Dds LLC | Dentist | 2245 W Dublin Granville Rd Ste 106, Worthington, OH 43085-3336 | 2018-10-20 |
| 1952807984 | Barbara L Mcclatchie | Dentist | 350 W Wilson Bridge Rd Ste 320, Worthington, OH 43085-2217 | 2018-03-30 |
| 1700389186 | Audrey Kathryn Eichenlaub | Dentist | 6641 N High St Ste 101, Worthington, OH 43085 | 2018-03-13 |
| 1851634455 | Heather Hull Appel | Dentist | 6641 N High St Ste 102, Worthington, OH 43085-4038 | 2013-04-02 |
| 1316224363 | Paul Michael Carlson | Dentist | 507 South Shore Drive, Worthington, MN 56187 | 2011-11-04 |
| 1831309558 | Tara L Haid | Dentist | 7100 N High St Ste 100, Worthington, OH 43085-2316 | 2007-05-23 |
| 1811103526 | Missy R Baker | Dentist | 69 E Wilson Bridge Rd, Worthington, OH 43085-2301 | 2007-05-16 |
| 1841418589 | Maureen A Sorensen | Dentist | 1029 3rd Ave, Worthington, MN 56187-2398 | 2007-04-20 |
| 1114096286 | John Scott Folk | Dentist | 5830 N High St, Worthington, OH 43085-3959 | 2006-11-06 |
| 1104902196 | Charles Wesley Beal | Dentist | 7174 North High Street, Worthington, OH 43085-2380 | 2006-10-31 |
| Find all providers in WORTHINGTON | ||||
| City | WORTHINGTON |
| Zip Code | 56187 |
Please comment or provide details below to improve the information on MODERN DENTAL PROFESSIONALS, MN PC.
| 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.