MITCHELL LEE PAGE (NPI# 1275649394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275649394 |
| Entity Type | Individual |
| Full Name | MITCHELL LEE PAGE |
| Credential | DDS, MS |
| Practice Address |
15785 95th Ave N Maple Grove MN 55369-4404 |
| Mailing Address |
15875 95th Avenue N Maple Grove MN 55369 |
| Practice Telephone | 7632334140 |
| Practice Fax Number | 7634203158 |
| Mailing Telephone | 7632334140 |
| Mailing Fax Number | 7634203158 |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2019-07-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223E0200X |
Dentist Specialization: Endodontics |
3179 | WI | Dental Providers |
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
10211 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BC/BS | 48114PA | 01 |
| MN | DELTA DENTAL | 391719255 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316127137 | Mitchell Kenneth Page | Social Worker | 100 Market Sq, # 7, Newington, CT 06111-2921 | 2007-11-08 |
| Street Address |
15785 95TH AVE N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-4404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699764431 | Beth Ann Gavren | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2005-10-14 |
| 1780010025 | Christopher Michael Rae | Dentist | 15785 95th Ave N, Maple Grove, MN 55369 | 2013-09-18 |
| 1992934418 | Katie Kickertz | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2009-07-06 |
| 1043467293 | Northland Dental Partners Pllc | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2008-08-19 |
| 1730390063 | Christina Marie Mccullough | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2007-05-25 |
| 1801959242 | Kristine Carol Rosenthal | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-18 |
| 1528120557 | Noah Andrew Rounds | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-15 |
| 1629137054 | Kelly Kristine Mehta | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-08 |
| 1942369749 | Kyle Patrick Gearhart | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-07 |
| 1023177011 | James Michael Healy | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| 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 |
|---|---|---|---|---|
| 1366679953 | Robert T Beasley | Dentist | 15785 95th Ave N., Maple Grove, MN 55369 | 2009-06-22 |
| 1659402477 | Gerald Anderson | Dentist | 14040 81st Ave N, Maple Grove, MN 55311-2250 | 2007-03-07 |
| 1811163314 | Allied Endodontic Specialists, P.a. | Dentist | 14040 81st Ave N, Maple Grove, MN 55311-2250 | 2008-05-05 |
| 1003009374 | Endodontic Professionals Pa Arbor Lakes Endodontics | Dentist | 12000 Elm Creek Blvd, Suite 240, Maple Grove, MN 55369 | 2007-08-21 |
| 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 |
| 1275034886 | Great River Endodontics | Dentist | 9381 Cedar St., Monticello, MN 55362 | 2018-02-28 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.