WOODDALE DENTAL GROUP PA (NPI# 1356404883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356404883 |
| Entity Type | Organization |
| Organization Name | WOODDALE DENTAL GROUP PA |
| Practice Address |
3401 Wooddale Ave S St Louis Park MN 55416-2340 |
| Practice Telephone | 9529293336 |
| Practice Fax Number | 9529293338 |
| Mailing Telephone | 9529293336 |
| Mailing Fax Number | 9529293338 |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL JAMES SPENCER (PRESIDENT) |
| Authorized Official Telephone | 9529293336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
3401 WOODDALE AVE S |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416-2340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447274089 | Teri Bretz | Dentist | 3401 Wooddale Ave S, St Louis Park, MN 55416-2340 | 2006-07-27 |
| 1528421278 | Thomas Hoover Dds Pa | Clinic/Center | 3401 Wooddale Ave S, St Louis Park, MN 55416-2340 | 2016-03-31 |
| 1992820153 | Orthodontic Care Group | Dentist | 3401 Wooddale Ave S, St Louis Park, MN 55416-2340 | 2007-03-20 |
| 1396899910 | James E. Cutcliffe | Dentist | 3401 Wooddale Ave S, St Louis Park, MN 55416-2340 | 2007-01-22 |
| 1902969991 | Neil Ronald Covin | Dentist | 3401 Wooddale Ave S, St Louis Park, MN 55416-2340 | 2006-12-19 |
| 1467515460 | Neil R. Covin, D.d.s., P.a. | Dentist | 3401 Wooddale Ave S, St Louis Park, MN 55416-2340 | 2006-12-19 |
| 1801959325 | Michael James Spencer | Dentist | 3401 Wooddale Ave S, St Louis Park, MN 55416-2340 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447691431 | Brooke Anne-marie Smars | Dentist | 8001 Highway 7 Ste 100, St Louis Park, MN 55426-3954 | 2013-07-08 |
| 1174797476 | Jeffrey H. Miller, Dds. | Dentist | 3345 Dakota Ave S, St Louis Park, MN 55416-2039 | 2008-04-17 |
| 1952525701 | Peter A. Berven | Dentist | 4033 Brookside Ave, St Louis Park, MN 55416-2808 | 2007-04-12 |
| 1497890263 | David Williams Hertelendy | Dentist | 4221 Minnetonka Blvd, St Louis Park, MN 55416-4129 | 2007-02-20 |
| 1386703189 | Nicole Amy Giddings | Dentist | 4959 Excelsior Blvd, #200, St Louis Park, MN 55416-3033 | 2006-12-07 |
| 1295808301 | Jenny A Schramm | Dentist | 5020 Minnetonka Blvd, St Louis Park, MN 55416-2255 | 2006-11-16 |
| 1134207087 | Solongo Purev | Dentist | 4820 Minnetonka Blvd, Suite #202, St Louis Park, MN 55416-2263 | 2006-11-01 |
| 1053405571 | David Katz Dds Pa | Dentist | 2934 Texas Ave S, St Louis Park, MN 55426-3032 | 2006-10-02 |
| 1831122639 | Douglas D. Talus | Dentist | 3645 Rhode Island Ave S, St Louis Park, MN 55426-4030 | 2006-07-08 |
| 1225086465 | Bernard Borkon | Dentist | 5407 Excelsior Blvd, Suite C, St Louis Park, MN 55416-2929 | 2006-05-04 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on WOODDALE DENTAL GROUP PA.
| 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.