METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD (NPI# 1245389246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245389246 |
| Entity Type | Organization |
| Organization Name | METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD |
| Practice Address |
1021 Bandana Blvd E Suite 121 Saint Paul MN 55108-5113 |
| Practice Telephone | 6512244969 |
| Practice Fax Number | 6512238047 |
| Mailing Telephone | 6512244969 |
| Mailing Fax Number | 6512238047 |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2015-05-14 |
| Authorized Official Name | JAMES D NICKMAN (PRESIDENT) |
| Authorized Official Telephone | 6512244969 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 518322700 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912056961 | Metropolitan Pediatric Dental Associates, Ltd | Dentist | 1519 Central Pkwy Ste 250, Eagan, MN 55121-2488 | 2007-01-09 |
| 1861654477 | Metropolitan Pediatric Dental Associates, Ltd | Dentist | 1021 Bandana Blvd E, Suite 121, Saint Paul, MN 55108-5113 | 2008-06-26 |
| 1083763023 | Metropolitan Pediatric Dental Associates, Ltd | Dentist | 700 Village Center Dr, Suite 110, North Oaks, MN 55127-3019 | 2007-01-09 |
| 1730238767 | Metropolitan Pediatric Dental Associates, Ltd | Dentist | 500 Osborne Rd Ne, Suite 345, Fridley, MN 55432-2765 | 2007-01-09 |
| Street Address |
1021 BANDANA BLVD E SUITE 121 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55108-5113 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700867967 | Charles Edward Kath | Dentist | 1021 Bandana Blvd E, Saint Paul, MN 55108-5113 | 2005-11-07 |
| 1871946459 | Rachel Zerby | Audiologist | 1021 Bandana Blvd E, Suite 100, Saint Paul, MN 55108-5113 | 2016-07-19 |
| 1285085274 | Megan Elyse Welborn | Dentist | 1021 Bandana Blvd E, Saint Paul, MN 55108-5113 | 2016-06-30 |
| 1821451774 | Edlund Dental, LLC | Dentist | 1021 Bandana Blvd E, Suite #105, Saint Paul, MN 55108-5113 | 2016-03-29 |
| 1417344110 | Laurel Urquhart Welch | Physical Therapist | 1021 Bandana Blvd E, Suite 123, Saint Paul, MN 55108-5113 | 2015-04-20 |
| 1124437108 | Kimberley Mullin | Physician Assistant | 1021 Bandana Blvd E, Suite 100, Saint Paul, MN 55108-5113 | 2014-08-04 |
| 1770990467 | Gabrielle Rivard | Physician Assistant | 1021 Bandana Blvd E, Saint Paul, MN 55108-5113 | 2014-07-15 |
| 1376976332 | Tara N Peacock | Nurse Practitioner | 1021 Bandana Blvd E, Suite 100, Saint Paul, MN 55108-5113 | 2013-08-14 |
| 1831521848 | Hnouchi Patricia Lochungvu | Family Medicine | 1021 Bandana Blvd E, Suite #100, Saint Paul, MN 55108-5113 | 2013-07-31 |
| 1447537162 | Michelle Josephine Parra | Physical Therapist | 1021 Bandana Blvd E, Suite 123, Saint Paul, MN 55108-5113 | 2011-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490677 | Kyle Leonard Bernier | Student in an Organized Health Care Education/Training Program | 1295 Bandana Blvd W, Suite 210, St. Paul, MN 55108 | 2019-07-25 |
| 1356870778 | Kathleen Louise Kocon | Marriage & Family Therapist | 2230 Como Ave., Saint Paul, MN 55108 | 2017-06-08 |
| 1871965830 | Jill Hansen | Specialist | 1449 Clevland Ave N, The Emily Program, Saint Paul, MN 55108 | 2015-10-29 |
| 1871821140 | Angela Joyce Anderson | Speech-Language Pathologist | 2266 Hillside Avenue, Saint Paul, MN 55108 | 2009-11-25 |
| 1265769418 | Dakota Baker | Counselor | 1360 Energy Park Drive Suite 340, St. Paul, MN 55108 | 2009-11-09 |
| 1255583449 | Suzanne Elizabeth Trunnell | Nurse Practitioner | 1020 Bandana Blvd. W, Aspen Medical Group--bandana Square, St. Paul, MN 55108 | 2008-10-21 |
| 1982851358 | Kimberly Joy Bahma | Pharmacist | 1295 Bandana Blvd, Suite 335, Saint Paul, MN 55108 | 2008-08-27 |
| 1952566093 | Caring Professionals Homecare, LLC | Home Health | 1543 Como Ave Ste 101, Saint Paul, MN 55108 | 2008-07-28 |
| 1700077344 | Archana Mani | Dentist | 1021 Bandana Blvd E Ste 121, Saint Paul, MN 55108 | 2007-08-08 |
| 1457554735 | Catherine Lawrence Scharlau | Psychologist | 1295 Bandana Blvd. North, Aspen Medical Group-behavioral Health, St. Paul, MN 55108 | 2007-06-06 |
| Find all providers in zip 55108 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700077344 | Archana Mani | Dentist | 1021 Bandana Blvd E Ste 121, Saint Paul, MN 55108 | 2007-08-08 |
| 1194145573 | Rachel Novotny Ecker | Dentist | 1021 Bandana Blvd E Ste 121, Saint Paul, MN 55108-5128 | 2014-04-23 |
| 1861654477 | Metropolitan Pediatric Dental Associates, Ltd | Dentist | 1021 Bandana Blvd E, Suite 121, Saint Paul, MN 55108-5113 | 2008-06-26 |
| 1538218615 | Christopher H Yue | Dentist | 411 Main St, Suite 400, Saint Paul, MN 55102-1080 | 2007-01-09 |
| 1134284235 | Michael H Flamenbaum | Dentist | 1021 Bandana Blvd E, Suite 121, Saint Paul, MN 55108-5113 | 2006-12-27 |
| 1700986098 | Brian Elmer Grove | Dentist | 1021 Bandana Blvd E, Suite 121, Saint Paul, MN 55108-5113 | 2006-09-25 |
| 1659473205 | Thomas James Mccarter | Dentist | 1514 White Bear Ave N, Saint Paul, MN 55106-1624 | 2006-09-03 |
| 1275642894 | Joshua Gordon Lipschultz | Dentist | 411 Main St, Suite 400, Saint Paul, MN 55102-1080 | 2006-08-29 |
| 1184691529 | James D Nickman | Dentist | 411 Main St, Suite 400, Saint Paul, MN 55102-1080 | 2006-03-03 |
| 1215904008 | Teresa L Fong | Dentist | 1021 Bandana Blvd E, Suite 121, Saint Paul, MN 55108-5113 | 2006-03-01 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55108 |
Please comment or provide details below to improve the information on METROPOLITAN PEDIATRIC DENTAL ASSOCIATES, LTD.
| 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.