MAPLE GROVE SMILES DENTISTRY, PC (NPI# 1396129433) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396129433 |
| Entity Type | Organization |
| Organization Name | MAPLE GROVE SMILES DENTISTRY, PC |
| Other Organization Name | MAPLE GROVE SMILES DENTISTRY |
| Practice Address |
12775 Elm Creek Blvd N Maple Grove MN 55369 |
| Mailing Address |
17000 Red Hill Ave Irvine CA 92614-5626 |
| Practice Telephone | 7632187005 |
| Practice Fax Number | 7634160498 |
| Mailing Telephone | 7148458890 |
| Mailing Fax Number | 9494741495 |
| Enumeration Date | 2015-07-18 |
| Last Update Date | 2015-07-18 |
| Authorized Official Name | DR. MICHAEL J PERPICH (OWNER) |
| Authorized Official Telephone | 7632187005 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Maple Grove Smiles Dentistry | Doing Business As Name - Organization |
| Street Address |
12775 ELM CREEK BLVD N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369 |
| 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 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| 1184049298 | Northwest Family Chiropractic Pa | Chiropractor | 7372 Kirkwood Court, Suite A, Maple Grove, MN 55369 | 2014-02-26 |
| Find all providers in zip 55369 | ||||
| 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 |
|---|---|---|---|---|
| 1942793989 | Lyle Arrian Corpuz Carlos | Dentist | 12737 Elm Creek Blvd N, Maple Grove, MN 55369-7045 | 2018-06-13 |
| 1346770500 | Hyeok Je Lee | Dentist | 6240 Quinwood Ln N # 100, Maple Grove, MN 55369-6384 | 2017-06-19 |
| 1326481284 | Grove Dentist Pa | Dentist | 13649 Grove Dr, Maple Grove, MN 55311-4405 | 2013-04-10 |
| 1619259181 | Cedar Island Dental | Dentist | 7378 Kirkwood Ct N, Maple Grove, MN 55369-5270 | 2011-09-12 |
| 1417240243 | Jennifer Marie Bertrand | Dentist | 7270 Forestview Ln N Ste 250, Maple Grove, MN 55369-5605 | 2011-05-26 |
| 1740508704 | Partners In Dentistry Ltd | Dentist | 17143 73rd Pl N, Maple Grove, MN 55311-2686 | 2010-05-13 |
| 1639337710 | Blue Ridge Dental Center Pa | Dentist | 13800 83rd Way N Ste 100, Maple Grove, MN 55369-7016 | 2008-05-27 |
| 1699977058 | Jodi Marie Burth | Dentist | 11256 86th Ave N, Maple Grove, MN 55369 | 2007-06-05 |
| 1124230800 | Matthew P Dale Dds Pa | Dentist | 13998 Maple Knoll Way # Ll103, Maple Grove, MN 55369-7004 | 2007-05-04 |
| 1538389093 | Michael Lawrence Colbert | Dentist | 10182 Lancaster Ln N, Maple Grove, MN 55369-3562 | 2007-04-26 |
| Find all providers in MAPLE GROVE | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
Please comment or provide details below to improve the information on MAPLE GROVE SMILES DENTISTRY, PC.
| 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.