ST. CROIX KIDDS PEDIATRIC DENTISTRY (NPI# 1407131618) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407131618 |
| Entity Type | Organization |
| Organization Name | ST. CROIX KIDDS PEDIATRIC DENTISTRY |
| Practice Address |
4951 Morehead Ave White Bear Lake MN 55110-2633 |
| Mailing Address |
400 2nd St S Suite 250 Hudson WI 54016-4000 |
| Practice Telephone | 6513244270 |
| Mailing Telephone | 7158080460 |
| Mailing Fax Number | 7158080142 |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |
| Authorized Official Name | DR. DARCY JAY RINDELAUB (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 7158080460 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
6666-015 | WI | Dental Providers |
| Street Address |
4951 MOREHEAD AVE |
| City | WHITE BEAR LAKE |
| State | MN |
| Zip Code | 55110-2633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467071084 | St. Catherine University School Based Health Clinic | Nurse Practitioner | 5045 Division Ave, White Bear Lake, MN 55110 | 2020-04-14 |
| 1922450618 | Lisa Marie Thatcher | Podiatrist | 4653 White Bear Pkwy., St. Paul, MN 55110 | 2016-07-06 |
| 1558725598 | White Bear Dentists, PC | Dentist | 1970 Buerkle Road, White Bear Lake, MN 55110 | 2016-04-06 |
| 1124486246 | Julie Blaske | Counselor | 1310 Hwy 96 E, Suite 200, White Bear Lake, MN 55110 | 2016-02-03 |
| 1851761514 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 1920 Buerkle Rd, White Bear Lake, MN 55110 | 2015-10-06 |
| 1821496969 | Leah Eichmiller | Acupuncturist | 2183 3rd Street, C/o Indulge Salon, White Bear Lake, MN 55110 | 2014-12-05 |
| 1447672084 | Ashley Rath | Chiropractor | 1247 Gun Club Rd., White Bear Lake, MN 55110 | 2014-01-16 |
| 1790121291 | Advanced Medical Home Care, LLC | Home Health | 2555 County Road E East, Suite 101, White Bear Lake, MN 55110 | 2013-05-11 |
| 1134468465 | Emergency Physicians Professional Association | Clinic/Center | 1159 E. County Road E, Vadnais Heights, MN 55110 | 2013-02-06 |
| 1639444284 | Rebecca Lynn Blaede | Counselor | 4858 Banning Avenue, White Bear Lake, MN 55110 | 2012-03-15 |
| Find all providers in zip 55110 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477025906 | Riverdale Kidds Pediatric Dentistry, Pllc | Dentist | 3585 124th Ave Nw Ste 400, Coon Rapids, MN 55433-1008 | 2018-12-21 |
| 1467924290 | Camp Smile Pediatric Dentistry Excelsior Pllc | Dentist | 675 Water St Ste 2, Excelsior, MN 55331-3072 | 2018-12-18 |
| 1932671765 | Camp Smile Pediatric Dentistry Chaska | Dentist | 111 Hundertmark Rd Ste 304n, Chaska, MN 55318-1587 | 2018-12-18 |
| 1538678057 | Blaine Kidds Pediatric Dentistry Pllc | Dentist | 1351 113th Ave Ne, Blaine, MN 55434-3874 | 2017-09-27 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1710367925 | Lindsay Bedeaux | Dentist | 7373 France Ave S Ste 400, Edina, MN 55435-4549 | 2015-06-02 |
| 1609272822 | Rochester Pediatric Dentistry LLC | Dentist | 1705 S Boradway Ave Ste B, Rochester, MN 55904-7960 | 2014-11-16 |
| 1396186813 | Central Minnesota Pediatric Dentists Pa | Dentist | 507 N Nokomis St Ste C, Alexandria, MN 56308-2353 | 2013-07-12 |
| 1265873707 | Central Minnesota Pediatric Dentists Pa | Dentist | 570 Humboldt Dr Ste 102, Big Lake, MN 55309-4844 | 2013-07-12 |
| 1013264621 | Northland Dental Partners | Dentist | 3507 Round Lake Blvd. Suite 900, Anoka, MN 55303 | 2012-08-14 |
| Find all providers with the same taxonomy | ||||
| City | WHITE BEAR LAKE |
| Zip Code | 55110 |
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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.