FOUR SEASONS DENTAL PA (NPI# 1194215616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1194215616 |
Entity Type | Organization |
Organization Name | FOUR SEASONS DENTAL PA |
Other Organization Name | FOUR SEASONS DENTAL PA |
Practice Address |
4205 Lancaster Ln N Ste 101 Plymouth MN 55441-1702 |
Mailing Address |
109 Bushaway Rd Ste 300 Wayzata MN 55391-2079 |
Practice Telephone | 7635592976 |
Practice Fax Number | 7635594852 |
Mailing Telephone | 9524750225 |
Enumeration Date | 2018-05-10 |
Last Update Date | 2018-05-10 |
Authorized Official Name | KERSTEN HOFFMAN (CLINIC ADMINISTRATOR) |
Authorized Official Telephone | 9524750225 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
Other Name | Type Code |
---|---|
Four Seasons Dental PA | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619072261 | Four Seasons Dental Pa | Dentist | 510 Se 1st St, Mineral Wells, TX 76067 | 2006-09-14 |
Street Address |
4205 LANCASTER LN N STE 101 |
City | PLYMOUTH |
State | MN |
Zip Code | 55441-1702 |
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 |
1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
Find all providers in zip 55441 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
1326670886 | Plymouth Ardent | Clinic/Center | 40400 Ann Arbor Rd E Ste 103, Plymouth, MI 48170-4590 | 2020-02-12 |
1427695063 | Beacon Dental Health PC | Clinic/Center | 1 Scobee Cir # 2a, Plymouth, MA 02360-4887 | 2019-12-03 |
1952965949 | Minnesota Sleep and Wellness LLC | Clinic/Center | 15600 36th Ave N Ste 270a, Plymouth, MN 55446-3369 | 2019-04-25 |
1134611122 | Chad W. Barber, Dds, PC | Clinic/Center | 9331 N Lilley Rd, Plymouth, MI 48170-4609 | 2018-06-05 |
1396258752 | Advanced Dental Care Clinic Sc | Clinic/Center | 62 S Pleasant View Road, Plymouth, WI 53073 | 2017-11-08 |
1053834481 | Mondale Dental | Clinic/Center | 10600 Old County Road 15 Ste 120, Plymouth, MN 55441-6205 | 2017-07-18 |
1902060213 | Thomas F. Rogers, D.d.s., P.C. | Clinic/Center | 141 Court St, Plymouth, MA 02360-3807 | 2008-07-16 |
1093939712 | Frank Gatyas,d.d.s.,s.c. | Clinic/Center | 623 E Mill St, Plymouth, WI 53073-1944 | 2007-04-12 |
1528674157 | Beacon Dental Health PC | Clinic/Center | 3 Market Xing, Plymouth, MA 02360-7841 | 2020-09-18 |
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.