MODERN DENTAL PROFESSIONALS (NPI# 1275716474) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275716474 |
| Entity Type | Organization |
| Organization Name | MODERN DENTAL PROFESSIONALS |
| Other Organization Name | MIDWEST DENTAL |
| Practice Address |
6563 Laketowne Pl Unit A Albertville MN 55301-4510 |
| Practice Telephone | 7634933600 |
| Practice Fax Number | 7634933602 |
| Mailing Telephone | 7634933600 |
| Mailing Fax Number | 7634933602 |
| Enumeration Date | 2007-12-11 |
| Last Update Date | 2007-12-11 |
| Authorized Official Name | DR. JEFFREY WILLIAM MOOS (CEO) |
| Authorized Official Telephone | 7159265050 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D11386 | MN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Midwest Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730788498 | Modern Dental Professionals | Dentist | 676 County Road 10 Ne, Blaine, MN 55434-2329 | 2020-10-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | MODERN DENTAL PROFESSIONALS - INDIANA, P.C. | 8105 Irvine Center Drive, Suite 1500, Irvine, CA 92618 |
| Colorado Business Entities | MODERN DENTAL PROFESSIONALS-COLORADO, P.C. | 1955 Arapahoe St Ste A, Denver, CO 80202 |
| Oklahoma Business Registrations | MODERN DENTAL PROFESSIONALS-OKLAHOMA, P.C. | 1833 S Morgan Rd, Oklahoma City, OK 73128 |
| Street Address |
6563 LAKETOWNE PL UNIT A |
| City | ALBERTVILLE |
| State | MN |
| Zip Code | 55301-4510 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629694963 | Jacob John Dale Held | Dentist | 6563 Laketowne Pl, Albertville, MN 55301-4510 | 2020-06-23 |
| 1386049948 | White Smiles Family Dentistry | Dentist | 6563 Laketowne Pl, A, Albertville, MN 55301-4510 | 2014-10-24 |
| 1528290673 | Excel Dentistry Pllc | Dentist | 6563 Laketowne Pl, Ste. A, Albertville, MN 55301-4510 | 2009-08-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780127373 | Shanda Gwen Gaunt | Speech-Language Pathologist | 11091 Jasen Ave Ne Suite 2, Courage Kenny Rehabilitation Institute Albertville Part, Albertville, MN 55301 | 2016-11-30 |
| 1124478110 | Chiropractic and Wellness Center of Albertville | Chiropractor | 5676 Lacentre Ave., Suite 204, Albertville, MN 55301 | 2016-06-21 |
| 1184073157 | Keith Henry Diers | Physical Therapist | 11091 Jason Ave Nw, Suite 2, Albertville, MN 55301 | 2016-06-09 |
| 1154613479 | Francis Ogeto Raini | Nurse Practitioner | 7046 Lambert Lane Ne, Albertville, MN 55301 | 2011-05-04 |
| 1770802019 | Chiropractic and Wellness Center of Albertville Pllc | Chiropractor | 5676 Lacentre Avenue Ne, Suite 202, Albertville, MN 55301 | 2010-05-26 |
| 1508054339 | Andrea Lynn Anderson | Pharmacist | 5698 Lacentre Ave Ne, Albertville, MN 55301 | 2007-10-05 |
| 1235311853 | Now Care Medical Centers | Clinic/Center | 11091 Jason Ave Ne, Albertville, MN 55301 | 2007-12-05 |
| 1205022845 | Stellis Health, Pa | Clinic/Center | 11091 Jason Ave Ne, Albertville, MN 55301 | 2007-09-18 |
| 1902080518 | Heidi Sawdey | Chiropractor | 5676 Lacentre Avenue, Albertville, MN 55301-0000 | 2007-12-19 |
| 1275863508 | Lori Hunt | Community Health Worker | 10482 64th Way, Albertville, MN 55301-3517 | 2010-01-08 |
| Find all providers in zip 55301 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306301643 | Affordable Dentures - Albertville, P.C. | Dentist | 3487 Us Highway 431, Albertville, AL 35950-0219 | 2019-01-31 |
| 1952825523 | Sand Mountain Dentistry, LLC | Dentist | 416 Martling Road, Albertville, AL 35951 | 2017-07-26 |
| 1801270301 | Lauren Kristine Phipps | Dentist | 5585 La Centre Ave Ste 500, Albertville, MN 55301-4686 | 2015-07-14 |
| 1639383128 | James William Porter II | Dentist | 100 Andrew St Ste A, Albertville, AL 35950-1964 | 2007-05-10 |
| 1821150707 | Louis F Lam | Dentist | 11091 Jason Ave Ne Ste 3, Albertville, MN 55301-4703 | 2006-12-15 |
| 1629028345 | Faith G Lira | Dentist | 5047 Jason Ave Ne, Albertville, MN 55301-9688 | 2006-05-11 |
| 1629694963 | Jacob John Dale Held | Dentist | 6563 Laketowne Pl, Albertville, MN 55301-4510 | 2020-06-23 |
| 1386049948 | White Smiles Family Dentistry | Dentist | 6563 Laketowne Pl, A, Albertville, MN 55301-4510 | 2014-10-24 |
| 1528473634 | Jacob L. Turner | Dentist | 100 Andrew St Ste A, Albertville, AL 35950-1964 | 2014-06-26 |
| 1790083632 | William C. Adams, Dmd | Dentist | 8835 Us Highway 431, Albertville, AL 35950-0161 | 2011-03-02 |
| Find all providers in ALBERTVILLE | ||||
| City | ALBERTVILLE |
| Zip Code | 55301 |
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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.