THE DENTAL SPECIALIST OF MINNESOTA, PLLC (NPI# 1215588660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215588660 |
| Entity Type | Organization |
| Organization Name | THE DENTAL SPECIALIST OF MINNESOTA, PLLC |
| Practice Address |
324 W Superior St Ste 824 Duluth MN 55802-1718 |
| Mailing Address |
2200 County Road C W Ste 2210 Roseville MN 55113-2551 |
| Practice Telephone | 2187277557 |
| Practice Fax Number | 2187271182 |
| Mailing Telephone | 6517462815 |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | SHANNON HESSE (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 6517462815 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Northern Endodontics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861914061 | The Dental Specialist of Minnesota, Pllc | Dentist | 2550 University Ave W Ste 155s, Saint Paul, MN 55114-1098 | 2017-07-10 |
| 1265097653 | The Dental Specialist of Minnesota, Pllc | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2019-05-01 |
| Street Address |
324 W SUPERIOR ST STE 824 |
| City | DULUTH |
| State | MN |
| Zip Code | 55802-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073122321 | Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2020-07-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063915239 | Jpw Counseling & Consultation | Social Worker | 302 W Superior St Ste 508, Duluth, MN 55802 | 2018-03-14 |
| 1134664311 | Amp Group, LLC | Counselor | 331 West Superior Street, Duluth, MN 55802 | 2016-12-27 |
| 1982151361 | Tiffany Riester | Counselor | 332 W Superior Street, Suite 300, Duluth, MN 55802 | 2016-09-02 |
| 1730635392 | Karina Krosbakken | Counselor | 332 W. Superior St., Suite 300, Duluth, MN 55802 | 2016-09-01 |
| 1437559051 | Natalie R Zwak | Dietitian, Registered | 26 E Superior St Ste 315, Duluth, MN 55802 | 2014-09-02 |
| 1447679279 | Valerie Lou Shelton | Registered Nurse | 118 E Superior St., Duluth, MN 55802 | 2014-04-09 |
| 1285063115 | Brian Bergstedt | Counselor | 332 West Superior Street, Suite 300, Duluth, MN 55802 | 2013-11-01 |
| 1508135948 | Karen Dee Turner | Counselor | 202 W. Superior Street, Suite 700, Duluth, MN 55802 | 2011-12-14 |
| 1497023410 | Jean Barrie Mcbride | Pharmacist | 1131 East Superior Street, Duluth, MN 55802 | 2011-12-05 |
| 1194092304 | Diane Murphy Winship | Pharmacist | 1331 Superior St, Duluth, MN 55802 | 2011-11-17 |
| Find all providers in zip 55802 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487863262 | Waheed A Malik | Dentist | 2405 Satellite Blvd., Suite 115, Duluth, GA 30096 | 2007-05-21 |
| 1568528404 | Thomas J Zbaracki Jr. | Dentist | 5005 Matterhorn Drive, Ste 1, Duluth, MN 55811 | 2006-12-28 |
| 1073122321 | Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2020-07-23 |
| 1174794002 | Georgia Endodontic Specialists | Dentist | 9590 Medlock Bridge Rd, Suite G, Duluth, GA 30097 | 2008-03-19 |
| 1982873964 | Rakesh Raina | Dentist | 1815 Satellite Blvd, Suite # 301, Duluth, GA 30097-5237 | 2008-02-25 |
| 1740465483 | Bilal Shah Khan | Dentist | 9590 Medlock Bridge Rd, Suite G, Duluth, GA 30097-4443 | 2007-12-31 |
| 1255515805 | Les Hale Kravitz | Dentist | 9590 Medlock Bridge Rd, Suite G, Duluth, GA 30097-4443 | 2007-12-18 |
| 1194909820 | Bruce D Rickoff | Dentist | 9590 Medlock Bridge Rd, Suite G, Duluth, GA 30097-4443 | 2007-12-17 |
| 1225102312 | Richard Lawrence Kronzer | Dentist | 324 W Superior St, Suite 530, Duluth, MN 55802-1701 | 2006-11-20 |
| 1366516460 | Kimberly Ann-davis Lindquist | Dentist | 324 W Superior St, Suite 530, Duluth, MN 55802-1701 | 2006-11-20 |
| Find all providers in DULUTH | ||||
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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.