BRIGHT SMILES DENTAL PROGRAM (NPI# 1427519529) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1427519529 |
Entity Type | Organization |
Organization Name | BRIGHT SMILES DENTAL PROGRAM |
Practice Address |
153 Cesar Chavez St Saint Paul MN 55107-2226 |
Practice Telephone | 6516027500 |
Practice Fax Number | 6516027580 |
Mailing Telephone | 6516027500 |
Mailing Fax Number | 6516027580 |
Enumeration Date | 2019-03-29 |
Last Update Date | 2019-03-29 |
Authorized Official Name | BLAKE DARSOW (CFO) |
Authorized Official Telephone | 6516027537 |
Is Organization Subpart | Y |
Parent Organization Name | WEST SIDE COMMUNITY HEALTH SERVICE |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
Street Address |
153 CESAR CHAVEZ ST |
City | SAINT PAUL |
State | MN |
Zip Code | 55107-2226 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104820661 | Carrie S Dickson | Advanced Practice Midwife | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2005-06-10 |
1700493137 | Carolina Gentry | Social Worker | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2020-09-29 |
1740890334 | Quest Diagnostics | Clinical Medical Laboratory | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2020-08-07 |
1316589195 | Sara Saini Maki | Pharmacist | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-10-13 |
1912556457 | Christine Jo Singer | Registered Nurse | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-09-07 |
1831745025 | Antionette Renee Estis | Advanced Practice Midwife | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-08-13 |
1467006700 | Faisa Hassan Abdi-omar | Midwife | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-07-25 |
1790338754 | Mikaela Pierson | Physician Assistant | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-07-18 |
1275005464 | Eli Eggen | Pharmacist | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2018-12-28 |
1689159360 | Morgan Llewellyn Mcdonald Weinert | Nurse Practitioner | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2018-09-28 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477944809 | Marina Castillo | Counselor | 143 Isabel St. W, Saint Paul, MN 55107 | 2015-02-06 |
1134540123 | Michelle M Lee | Social Worker | 106 Water Street/3rd Floor, Umbrella Tree Studios, St. Paul, MN 55107 | 2013-12-18 |
1376748574 | Mary E. A. Horoshak | Physical Therapist | 155 S Wabasha St, Suite 130, St. Paul, MN 55107 | 2007-06-18 |
1821156050 | Amherst H. Wilder Foundation | Assisted Living Facility | 469 Ada St, Saint Paul, MN 55107 | 2006-12-04 |
1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
1780753681 | Chad Randal Vickers | Nurse Practitioner | 135 Colorado Street East, Saint Paul, MN 55107 | 2006-11-06 |
1225122872 | Elizabeth E Frost | Family Medicine | 153 Cesar Chavez Street, St Paul, MN 55107 | 2006-10-03 |
1215457890 | Elizabeth Smith Zaremba | Dietitian, Registered | 205 Wabasha St S, Mail Stop 31300a, St Paul, MN 55107 | 2017-06-23 |
1366819609 | Brittany Leach | Advanced Practice Midwife | 624 Smith Ave S, Saint Paul, MN 55107 | 2015-08-21 |
1003293101 | Huiying Guo | Family Medicine | 205 Wabasha St S, Saint Paul, MN 55107 | 2015-04-28 |
Find all providers in zip 55107 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144860685 | Mn Community Care- Downtown Clinic Dental | Clinic/Center | 424 Dorothy Day Place, Saint Paul, MN 55102-1025 | 2020-01-13 |
1184980112 | St. Anthony Park Dental Arts, P.a. | Clinic/Center | 2282 Como Ave, Saint Paul, MN 55108-1722 | 2012-04-04 |
1417007436 | West Side Community Health Services, Inc. | Clinic/Center | 478 Robert St S, Saint Paul, MN 55107-2236 | 2007-01-11 |
1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
1154933661 | Grand Avenue Dental, LLC | Clinic/Center | 960 Grand Ave, Saint Paul, MN 55105-3014 | 2020-08-18 |
1043870645 | St Paul Oral Surgery and Dental Implants LLC | Clinic/Center | 2550 University Ave W Ste 115n, Saint Paul, MN 55114-1097 | 2019-06-17 |
1033675871 | N&m Dds | Clinic/Center | 483 Brimhall St, Saint Paul, MN 55116-1508 | 2019-02-18 |
1871064105 | Luna Land Dental, Corp. | Clinic/Center | 1215 Rice St, Saint Paul, MN 55117-4538 | 2018-12-16 |
1689181489 | Luna Land Dental, Corp. | Clinic/Center | 555 Wabasha St N Ste 250, Saint Paul, MN 55102-1673 | 2018-01-03 |
1144735234 | Lisa Mcgann, Dds, Pa | Clinic/Center | 757 Cleveland Ave S Ste 2, Saint Paul, MN 55116-1301 | 2017-12-11 |
Find all providers in SAINT PAUL |
City | SAINT PAUL |
Zip Code | 55107 |
Please comment or provide details below to improve the information on BRIGHT SMILES DENTAL PROGRAM.
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.