CITY CENTER DENTAL, L.L.C. (NPI# 1205261195) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205261195 |
| Entity Type | Organization |
| Organization Name | CITY CENTER DENTAL, L.L.C. |
| Other Organization Name | CENTRE FOR DISTINCTIVE DENTISTRY |
| Practice Address |
8375 City Centre Dr Woodbury MN 55125-3324 |
| Practice Telephone | 6517398573 |
| Practice Fax Number | 6517395517 |
| Mailing Telephone | 6517398573 |
| Mailing Fax Number | 6517395517 |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2013-09-10 |
| Authorized Official Name | DR. CHRISTOPHER M CHMIEL (DENTIST) |
| Authorized Official Telephone | 6517398573 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D11040 | MN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Centre for Distinctive Dentistry | Former Legal Business Name - Organization |
| Street Address |
8375 CITY CENTRE DR |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-3324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| 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 |
|---|---|---|---|---|
| 1932769676 | Kristina Pokharel | Dentist | 8525 Titanium Cir, Woodbury, MN 55129-2227 | 2019-06-14 |
| 1104318328 | Nailah Khalfan | Dentist | 48 Westwood Ct, Woodbury, NY 11797-2624 | 2018-06-04 |
| 1255880944 | Salute Dental | Dentist | 2101 Woodwinds Dr Ste 500, Woodbury, MN 55125-2527 | 2016-09-23 |
| 1164877288 | Jurim Dental Group | Dentist | 370 Crossways Park Dr, Woodbury, NY 11797-2050 | 2016-04-26 |
| 1639544141 | Corsi Dental Associates | Dentist | 161 N Broad St, Woodbury, NJ 08096-1718 | 2015-12-09 |
| 1477929008 | Avra Miriam Louis | Dentist | 85 Woodlake Dr W, Woodbury, NY 11797-2304 | 2015-08-18 |
| 1053791954 | Rebecca J Petersen | Dentist | 8325 Seasons Parkway Suite 103, Healthpartners Woodbury Dental, Woodbury, MN 55125-3477 | 2015-06-04 |
| 1518231596 | Woodbury Dental Arts Pa | Dentist | 2070 Eagle Creek Ln, Woodbury, MN 55129-3216 | 2012-03-08 |
| 1134497621 | Alan Jeffrey Wilensky | Dentist | 2 Hunters Run, Woodbury, NY 11797-1100 | 2011-12-12 |
| 1942583265 | Daniel Patrick Ehrmanntraut | Dentist | 7582 Currell Blvd Ste 210, Woodbury, MN 55125-8210 | 2011-09-22 |
| Find all providers in WOODBURY | ||||
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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.