DR. PRASAD ANIL BASTODKAR (NPI# 1215121884) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215121884 |
| Entity Type | Individual |
| Full Name | DR. PRASAD ANIL BASTODKAR |
| Credential | DDS |
| Practice Address |
7136 University Ave Ne Fridley MN 55432-3100 |
| Practice Telephone | 7635741639 |
| Mailing Telephone | 7635741639 |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D11738 | MN | Dental Providers |
| Street Address |
7136 UNIVERSITY AVE NE |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-3100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992848808 | Christopher Michael De La Mater | Oral & Maxillofacial Surgery | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-14 |
| 1245550912 | Austin C Seward | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2010-06-04 |
| 1508900515 | Paul Francis Stannard | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1922142918 | Laurie Allyn Goldenberg | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1013051028 | William Louis Wilkie | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1033253984 | Joseph Allen Huss | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1427192368 | Robert Blackford Gillum IIi | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1366586372 | Richard Tad Pihlstrom | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1457495491 | Associated Oral and Maxillofacial Surgeons, Pa | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245550912 | Austin C Seward | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2010-06-04 |
| 1508900515 | Paul Francis Stannard | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1922142918 | Laurie Allyn Goldenberg | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1013051028 | William Louis Wilkie | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1033253984 | Joseph Allen Huss | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1427192368 | Robert Blackford Gillum IIi | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1366586372 | Richard Tad Pihlstrom | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-16 |
| 1457495491 | Associated Oral and Maxillofacial Surgeons, Pa | Dentist | 7136 University Ave Ne, Fridley, MN 55432-3100 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1285294611 | Brian Michael Laing | Dentist | 7-147 Moos Health Science Tower, 515 Delaware Street S.e., Minneapolis, MN 55455-0357 | 2019-06-18 |
| 1295218303 | Advanced Oral Surgery | Dentist | 19925 Idealic Ave, Lakeville, MN 55044-2003 | 2018-09-13 |
| 1205366002 | Derek Miller | Dentist | 7-174 Moos Tower 515 Delaware St. S, U of M Oral Surgery, Minneapolis, MN 55455 | 2017-06-14 |
| 1497113674 | West Lakes Dentistry, Pa | Dentist | 5205 Shoreline Dr, Mound, MN 55364-1770 | 2016-02-03 |
| 1003203498 | Tyler John Varhol | Dentist | 550 County Road D W Ste 12, New Brighton, MN 55112-3517 | 2015-04-23 |
| 1225458391 | Levi Zarbano | Dentist | 2550 University Ave W Ste 115n, Saint Paul, MN 55114-1097 | 2014-04-16 |
| 1154760932 | John Salek-raham | Dentist | 700 Village Center Dr., Ste 170, North Oaks, MN 55127-3025 | 2013-06-14 |
| 1649511585 | Kristopher Lee Hasstedt | Dentist | Dentists of Woodbury, 7150 Valley Creek Plaza Ste #230, Woodbury, MN 55125 | 2013-03-01 |
| 1396095048 | Dental Specialists of Minnesota, Pllc | Dentist | 3360 Northdale Blvd., Coon Rapids, MN 55448-1825 | 2012-09-10 |
| Find all providers with the same taxonomy | ||||
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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.