THE DENTAL SPECIALIST OF MINNESOTA, PLLC (NPI# 1265097653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265097653 |
| Entity Type | Organization |
| Organization Name | THE DENTAL SPECIALIST OF MINNESOTA, PLLC |
| Practice Address |
13961 60th St N Stillwater MN 55082-1053 |
| Mailing Address |
2200 County Road C W Ste 2210 Roseville MN 55113-2551 |
| Practice Telephone | 6517603681 |
| Practice Fax Number | 6517603683 |
| Enumeration Date | 2019-05-01 |
| 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 | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers |
| Other Name | Type Code |
|---|---|
| The Dental Specialist St Croix Valley | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215588660 | The Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2019-09-26 |
| 1861914061 | The Dental Specialist of Minnesota, Pllc | Dentist | 2550 University Ave W Ste 155s, Saint Paul, MN 55114-1098 | 2017-07-10 |
| Street Address |
13961 60TH ST N |
| City | STILLWATER |
| State | MN |
| Zip Code | 55082-1053 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265439350 | Barry Robert Stromberg | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2005-07-05 |
| 1538691423 | Valentina Ronning | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2017-03-30 |
| 1972985364 | Michelle Parker | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2015-06-23 |
| 1013398908 | Timothy Huska | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2015-06-16 |
| 1215368725 | Straight Smiles, Pllc | Clinic/Center | 13961 60th St N, Stillwater, MN 55082-1053 | 2013-12-09 |
| 1245669787 | Pdg, P.a. | Clinic/Center | 13961 60th St N, Stillwater, MN 55082-1053 | 2013-11-05 |
| 1982966529 | Chad Joseph Wert | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2012-06-11 |
| 1407082738 | Kelsey Joan Eshleman | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2009-06-01 |
| 1689842841 | St. Croix Valley Dental, Pllc | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2008-02-11 |
| 1679751234 | Amy P Deyoung | Dentist | 13961 60th St N, Stillwater, MN 55082-1053 | 2008-02-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154947455 | Lucas William Schmidt | Optometrist | 2950 Curve Crest Blvd, Stillwater, Stillwater, MN 55082 | 2020-06-23 |
| 1982238085 | Jerald Haley | Technician | 924 6th Ave. S., Stillwater, MN 55082 | 2020-02-27 |
| 1801457387 | Sun Trad Chin Acu Mn LLC | Acupuncturist | Compass Center for Healing, 116 Chestnut St. E., Stillwater, MN 55082 | 2019-06-25 |
| 1598243990 | Carlson Distinctive Dentistry, Pllc | Dentist | 1701 Curve Crest Blvd W Ste 100, Stillwater, MN 55082 | 2018-07-30 |
| 1073001624 | Lindsay Beth Briggs | Chiropractor | 200 Chestnut St E, Ste 202, Stillwater, MN 55082 | 2018-04-30 |
| 1578932943 | Group Health Plan, Inc | Family Medicine | 921 Greeley Street, Stillwater, MN 55082 | 2015-09-16 |
| 1184001919 | Grant Rohrig | Specialist/Technologist | 8727 Jeffrey Ave North, Stillwater, MN 55082 | 2015-04-30 |
| 1346688991 | Kellie Ann Seth | Chiropractor | 200 Chestnut St E Ste 202, Stillwater, MN 55082 | 2013-06-05 |
| 1770928426 | Rivertown Animal Hospital | Veterinarian | 135 New England Place, Stillwater, MN 55082 | 2013-05-08 |
| 1285929265 | Healtheast Medical Research Institute | Dietitian, Registered | 2900 Curve Crest Blvd, Stillwater, MN 55082 | 2011-06-17 |
| Find all providers in zip 55082 | ||||
| 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 |
|---|---|---|---|---|
| 1467627364 | Central Oklahoma Oral & Maxillofacial Surgery Associates | Dentist | 812 S Pine St, Stillwater, OK 74074-4349 | 2008-04-23 |
| 1508058322 | Great Lakes Oral & Maxillofacial Surgery, P.a. | Dentist | 2850 Curve Crest Blvd, Suite 130, Stillwater, MN 55082 | 2007-08-15 |
| 1013096494 | Ross Edwin Sethman | Dentist | 812 South Pine Street, Stillwater, OK 74074 | 2006-11-04 |
| 1053381061 | Martin A Tahara | Dentist | 1701 Curve Crest Blvd W, Suite 108, Stillwater, MN 55082-6044 | 2006-01-23 |
| 1629146964 | Richard Reed Miller | Dentist | 812 South Pine Street, Stillwater, OK 74074 | 2006-12-04 |
| 1427129717 | St Croix Oral, Maxillofacial & Implant Surgery, P.a. | Dentist | 1701 Curve Crest Blvd W, Suite 108, Stillwater, MN 55082-6044 | 2006-11-10 |
| 1023088622 | Steven D Johnson | Dentist | 1701 Curve Crest Blvd W, Suite 108, Stillwater, MN 55082-6044 | 2006-01-25 |
| 1235128992 | Richard William Brunton | Dentist | 2850 Curve Crest Blvd W, Stillwater, MN 55082-4079 | 2005-10-17 |
| 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 | ||||
| City | STILLWATER |
| Zip Code | 55082 |
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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.