GREAT RIVER ENDODONTICS (NPI# 1275034886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275034886 |
| Entity Type | Organization |
| Organization Name | GREAT RIVER ENDODONTICS |
| Practice Address |
9381 Cedar St. Monticello MN 55362 |
| Mailing Address |
622 Roosevelt Rd. Suite 180 St. Cloud MN 56301 |
| Practice Telephone | 7632952222 |
| Practice Fax Number | 7632952249 |
| Mailing Telephone | 3202595078 |
| Mailing Fax Number | 3202591484 |
| Enumeration Date | 2018-02-28 |
| Last Update Date | 2018-02-28 |
| Authorized Official Name | THOMAS ANDREW KARN (PRESIDENT) |
| Authorized Official Telephone | 3202595078 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
11880 | MN | Dental Providers |
| Street Address |
9381 CEDAR ST. |
| City | MONTICELLO |
| State | MN |
| Zip Code | 55362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467994962 | Jessica Borgstrom | Advanced Practice Midwife | 1001 Hart Blvd #100, Monticello, MN 55362 | 2016-11-15 |
| 1972922078 | Ashby Optometry PC | Optometrist | 1447 East 7th Street, Monticello, MN 55362 | 2014-04-16 |
| 1740612621 | Sarah Rowe | Physical Therapist | 1260 Mn-25, Monticello, MN 55362 | 2013-08-02 |
| 1144573775 | Kelley M Mcgowan | Physical Therapist | 211 Hwy 25, Monticello, MN 55362 | 2012-10-19 |
| 1275801581 | Roger William Hedtke | Pharmacist | 135 East Broadway, Monticello, MN 55362 | 2011-12-01 |
| 1811299019 | Pamela Marie Bertram | Social Worker | 228 W Broadway St, Monticello, MN 55362 | 2010-11-22 |
| 1265768220 | Back 2 Health Chiropractic, P.a. | Chiropractor | 1125 South Cedar St, Suite 109, Monticello, MN 55362 | 2009-10-27 |
| 1538328059 | Lakeland Family Dental | Dentist | 106 Broadway Street East, Monticello, MN 55362 | 2008-06-09 |
| 1205038163 | Buffalo Dental Center | Dentist | 106 1 In A Half W Broadway, Monticello, MN 55362 | 2007-06-04 |
| 1770795924 | Monticello Physical Therapy & Sports Medicine, LLC | Physical Therapist | 1125 S Cedar Street Suite 103, Monticello, MN 55362 | 2007-05-03 |
| Find all providers in zip 55362 | ||||
| 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 |
|---|---|---|---|---|
| 1831344399 | Joel A. Hofflich | Dentist | 60 Jefferson St, Suite 6, Monticello, NY 12701-1122 | 2008-11-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071199 | Dental Specialist of Minnesota, Pllc | Dentist | 18258 Minnetonka Blvd Ste 100, Wayzata, MN 55391-3324 | 2020-07-29 |
| 1215588660 | The Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2019-09-26 |
| 1780236539 | Modern Care Endodontics of Apple Valley | Dentist | 15160 Foliage Ave Ste 100, Apple Valley, MN 55124-5916 | 2019-07-11 |
| 1699268052 | Christopher Rex Lai | Dentist | 8-166 Moos Health Sciene Tower, 515 Delaware St. Se, Minneapolis, MN 55455 | 2018-06-11 |
| 1699272427 | Group Health Plan Inc | Dentist | 5500 Excelsior Blvd, St Louis Park, MN 55416-2935 | 2018-04-09 |
| 1225533037 | Younghyup Byun | Dentist | 1900 Kruchten Ct S Ste 100, Sartell, MN 56377-4731 | 2018-03-26 |
| 1417464157 | Deer River Dental Clinic | Dentist | 111 Main Street E, Deer River, MN 56636 | 2018-01-03 |
| 1174045975 | The Dental Specialists of Minnesota, Pllc | Dentist | 4640 Nicols Rd Ste 202, Eagan, MN 55122-7400 | 2017-07-13 |
| 1861914061 | The Dental Specialist of Minnesota, Pllc | Dentist | 2550 University Ave W Ste 155s, Saint Paul, MN 55114-1098 | 2017-07-10 |
| 1386189272 | Wayzata Endodontics, P.a. | Dentist | 101 Lake Street West, Suite 100, Wayzata, MN 55391 | 2016-12-30 |
| Find all providers with the same taxonomy | ||||
| City | MONTICELLO |
| Zip Code | 55362 |
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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.