MAIZE LLC (NPI# 1407362205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407362205 |
| Entity Type | Organization |
| Organization Name | MAIZE LLC |
| Other Organization Name | BLUEJAY FAMILY DENTISTRY |
| Practice Address |
1975 11th Ave E Maplewood MN 55109-5148 |
| Mailing Address |
2860 105th Ave Ne Blaine MN 55449-5212 |
| Practice Telephone | 6517702900 |
| Mailing Telephone | 6127354818 |
| Enumeration Date | 2017-12-17 |
| Last Update Date | 2017-12-17 |
| Authorized Official Name | DR. ALEXIS SIMONSON (OWNER) |
| Authorized Official Telephone | 6127354818 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Bluejay Family Dentistry | Doing Business As Name - Organization |
| Street Address |
1975 11TH AVE E |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-5148 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891848362 | Mary J. Pariseau | Dentist | 1975 11th Ave E, Maplewood, MN 55109-5148 | 2007-01-19 |
| 1720697808 | Russomanno Keane Dds Pa | Dentist | 1975 11th Ave E, Maplewood, MN 55109-5148 | 2020-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063825701 | Nerness Endodontics, P.C. | Clinic/Center | 2480 White Bear Ave N Ste 202, Maplewood, MN 55109-4567 | 2014-06-10 |
| 1225640865 | Dr. Roger C. Stoddard Dds, Pa | Clinic/Center | 2480 White Bear Ave N Ste 202, Maplewood, MN 55109-4567 | 2020-08-17 |
| 1861054090 | Dr Michael R Henrickson Dds Plc | Clinic/Center | 1560 Beam Ave Ste A, Maplewood, MN 55109-1171 | 2019-07-09 |
| 1053807016 | 123 Brush Dental LLC | Clinic/Center | 1670 Beam Ave, Ste 202, Maplewood, MN 55109 | 2018-07-02 |
| 1477871457 | Institute of Facial Surgery St Paul, Pllc | Clinic/Center | 1774 Cope Ave E, Suite 140, Maplewood, MN 55109-2662 | 2010-05-14 |
| 1659355055 | Quality Dentistry Inc | Clinic/Center | 1736 Cope Ave E, Maplewood, MN 55109-2610 | 2005-11-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710025 | Theresa M. Snell | Clinic/Center | 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 | 2020-11-05 |
| 1376143248 | James M. Williams, D.d.s., P.a. | Clinic/Center | 620 Union St S, Mora, MN 55051-1818 | 2020-10-29 |
| 1235746058 | Asp Dental, PC | Clinic/Center | 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 | 2020-09-25 |
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1518574532 | Stillwater Family Dental | Clinic/Center | 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 | 2020-09-24 |
| 1093321531 | Barnett Dental Inc | Clinic/Center | 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 | 2020-09-21 |
| 1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
| 1770195158 | Mark T. Sherman Dds Pa | Clinic/Center | 31011 Rasmussen Rd, Pequot Lakes, MN 56472-1227 | 2020-08-18 |
| 1689286015 | Lifelong Dental Care | Clinic/Center | 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 | 2020-08-18 |
| 1528678497 | Custom Smiles Dentistry, Pllc | Clinic/Center | 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
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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.