CENTRAL MINNESOTA PEDIATRIC DENTISTS PA (NPI# 1265873707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265873707 |
| Entity Type | Organization |
| Organization Name | CENTRAL MINNESOTA PEDIATRIC DENTISTS PA |
| Practice Address |
570 Humboldt Dr Ste 102 Big Lake MN 55309-4844 |
| Mailing Address |
1900 Centracare Cir Ste 350 Saint Cloud MN 56303-5000 |
| Practice Telephone | 3202530272 |
| Practice Fax Number | 3202512661 |
| Mailing Telephone | 3202530272 |
| Mailing Fax Number | 3202512661 |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |
| Authorized Official Name | DR. MICHAEL W STEIL (PARTNER/OWNER) |
| Authorized Official Telephone | 3202530272 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D11344 | MN | Dental Providers |
| N | 122300000X | Dentist | D7765 | MN | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D12885 | MN | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D11073 | MN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396186813 | Central Minnesota Pediatric Dentists Pa | Dentist | 507 N Nokomis St Ste C, Alexandria, MN 56308-2353 | 2013-07-12 |
| 1891136321 | Central Minnesota Pediatric Dentists Pa | Dentist | 1100 19th Ave Sw, Willmar, MN 56201-5288 | 2013-07-12 |
| Street Address |
570 HUMBOLDT DR STE 102 |
| City | BIG LAKE |
| State | MN |
| Zip Code | 55309-4844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356986475 | Barbro E Strom Langley | Technician | 16901 River View Cir, Big Lake, MN 55309 | 2019-11-13 |
| 1629589544 | Pdg, Pa | Clinic/Center | 16991 198th Ave Nw, Big Lake, MN 55309 | 2017-10-18 |
| 1669821765 | Laura Ann Dill | Dentist | 290 Eagle Lake Rd N, Big Lake, MN 55309 | 2016-06-09 |
| 1295008068 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 171 Henry Road, Big Lake, MN 55309 | 2012-02-09 |
| 1013280882 | Cherrywood Advanced Living, LLC | Assisted Living Facility | 177 Henry Road, Big Lake, MN 55309 | 2012-02-09 |
| 1760704712 | Mary Ellen Venzke | Adult Companion | 19729 183rd Avenue, Big Lake, MN 55309 | 2010-02-18 |
| 1174700611 | Country Services Inc | Case Management | 641 Park Ave E, Big Lake, MN 55309 | 2008-01-28 |
| 1942481593 | Monticello Dental Group | Dentist | 20460 Co. Rd.11 Nw, Big Lake, MN 55309 | 2007-11-23 |
| 1336367242 | Family Prospective Resources, Inc | Marriage & Family Therapist | 35 Lake St So, Big Lake, MN 55309 | 2007-04-23 |
| 1598983470 | Jennifer Ann Lawrence | Marriage & Family Therapist | 35 Lake Street South #200, Big Lake, MN 55309 | 2007-04-23 |
| Find all providers in zip 55309 | ||||
| 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 |
|---|---|---|---|---|
| 1477025906 | Riverdale Kidds Pediatric Dentistry, Pllc | Dentist | 3585 124th Ave Nw Ste 400, Coon Rapids, MN 55433-1008 | 2018-12-21 |
| 1467924290 | Camp Smile Pediatric Dentistry Excelsior Pllc | Dentist | 675 Water St Ste 2, Excelsior, MN 55331-3072 | 2018-12-18 |
| 1932671765 | Camp Smile Pediatric Dentistry Chaska | Dentist | 111 Hundertmark Rd Ste 304n, Chaska, MN 55318-1587 | 2018-12-18 |
| 1538678057 | Blaine Kidds Pediatric Dentistry Pllc | Dentist | 1351 113th Ave Ne, Blaine, MN 55434-3874 | 2017-09-27 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1710367925 | Lindsay Bedeaux | Dentist | 7373 France Ave S Ste 400, Edina, MN 55435-4549 | 2015-06-02 |
| 1609272822 | Rochester Pediatric Dentistry LLC | Dentist | 1705 S Boradway Ave Ste B, Rochester, MN 55904-7960 | 2014-11-16 |
| 1396186813 | Central Minnesota Pediatric Dentists Pa | Dentist | 507 N Nokomis St Ste C, Alexandria, MN 56308-2353 | 2013-07-12 |
| 1013264621 | Northland Dental Partners | Dentist | 3507 Round Lake Blvd. Suite 900, Anoka, MN 55303 | 2012-08-14 |
| 1407131618 | St. Croix Kidds Pediatric Dentistry | Dentist | 4951 Morehead Ave, White Bear Lake, MN 55110-2633 | 2011-10-19 |
| 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.