MINNESOTA DENTAL PROFESSIONALS, P.C. (NPI# 1447896733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447896733 |
| Entity Type | Organization |
| Organization Name | MINNESOTA DENTAL PROFESSIONALS, P.C. |
| Practice Address |
654 Central Ave E Saint Michael MN 55376-9632 |
| Practice Telephone | 6122252502 |
| Mailing Telephone | 6122252502 |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |
| Authorized Official Name | JESSICA BRITT (CREDENTIALING COORDINATOR) |
| Authorized Official Telephone | 2175405100 |
| Is Organization Subpart | Y |
| Parent Organization Name | MINNESOTA DENTAL PROFESSIONALS, P.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Town Center Dental Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619451192 | Minnesota Dental Professionals, P.C. | Dentist | 107 12th St Sw Ste 2, Forest Lake, MN 55025-1467 | 2018-09-20 |
| 1154972909 | Minnesota Dental Professionals, P.C. | Dentist | 15243 Nowthen Blvd Nw, Ramsey, MN 55303-6138 | 2019-09-24 |
| 1245881093 | Minnesota Dental Professionals, P.C. | Dentist | 11237 Foley Blvd Nw, Coon Rapids, MN 55448-3389 | 2019-09-24 |
| 1225696925 | Minnesota Dental Professionals, P.C. | Dentist | 5901 94th Ave N Ste 105, Brooklyn Park, MN 55443-2389 | 2019-05-29 |
| 1043715204 | Minnesota Dental Professionals, P.C. | Dentist | 16138 Pilot Knob Rd, Lakeville, MN 55044 | 2018-03-28 |
| 1073063103 | Minnesota Dental Professionals, P.C. | Dentist | 825 Nicollet Mall, Ste 425, Minneapolis, MN 55402-2606 | 2016-10-13 |
| Street Address |
654 CENTRAL AVE E |
| City | SAINT MICHAEL |
| State | MN |
| Zip Code | 55376-9632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750949012 | Hillary Noelle Mashak Johnson | Dentist | 654 Central Ave E, Saint Michael, MN 55376-9632 | 2019-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417513128 | Jacqueline Jensen | Physical Therapist | 601 Central Ave W, Suite 102, St Michael, MN 55376 | 2019-05-17 |
| 1902308901 | Great Lakes Chiropractic of St. Michael Pllc Ltd | Chiropractor | 116 Central Ave E, Saint Michael, MN 55376 | 2018-03-06 |
| 1073050704 | Catherine Passe | Registered Nurse | 600 Central Street Avenue East, St Michael, MN 55376 | 2017-01-19 |
| 1518208313 | Allison Rae Delaney | Speech-Language Pathologist | 403 East Central Ave, Suite 102, Sunny Days Therapy, St. Michael, MN 55376 | 2013-03-05 |
| 1902195357 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 9 Central Ave E, Saint Michael, MN 55376 | 2011-04-06 |
| 1629148523 | John Richard Biorn | Dentist | 399 East Central Ave, St. Michael, MN 55376 | 2006-11-08 |
| 1124096730 | Catherine T Pham | Pediatrics | 4300 Edgewood Drive Ne, St. Michael, MN 55376 | 2006-03-09 |
| 1295256345 | Caleb John Mol | Marriage & Family Therapist | 703 Thielen Dr, Saint Michael, MN 55376 | 2017-06-29 |
| 1508022922 | Katie J Stangl | Marriage & Family Therapist | 703 Thielen Dr, Saint Michael, MN 55376 | 2008-08-05 |
| 1225100811 | Posthumus & Biorn, Inc. | Dentist | 399 Central Ave E, Saint Michael, MN 55376-0279 | 2006-11-15 |
| Find all providers in zip 55376 | ||||
| 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 |
|---|---|---|---|---|
| 1750949012 | Hillary Noelle Mashak Johnson | Dentist | 654 Central Ave E, Saint Michael, MN 55376-9632 | 2019-06-03 |
| 1902965890 | Eric Todd Carlson | Dentist | 12725 43rd St Ne Ste 202, Saint Michael, MN 55376-4929 | 2006-12-06 |
| 1225100811 | Posthumus & Biorn, Inc. | Dentist | 399 Central Ave E, Saint Michael, MN 55376-0279 | 2006-11-15 |
| 1982789731 | David Albert Desimone | Dentist | 12725 43rd St Ne, Suite 202, Saint Michael, MN 55376-4900 | 2006-10-26 |
| 1114130010 | Northwest Family Dental Center Tn | Dentist | 12725 43rd St Ne, Suite 202, Saint Michael, MN 55376-4900 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001149 | Kalyan Chakravarthy Kondreddi | Dentist | 327 Western Ave Ste A, Fergus Falls, MN 56537-2403 | 2020-10-20 |
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1770190951 | Bluff Creek Dental Pllc | Dentist | 600 Market St Ste 130, Chanhassen, MN 55317-4570 | 2020-09-30 |
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1073128153 | Michael W Flinn Dds, Pa | Dentist | 200 Firewood Drive, Redwood, MN 56283 | 2020-09-15 |
| 1770196891 | Thomas J Hoeffel Dds Pa | Dentist | 2819 Hamline Ave N Ste 104, Roseville, MN 55113-7718 | 2020-08-28 |
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 1679182687 | Downtown Dental Center Pllc | Dentist | 825 Nicollet Mall Ste 1427, Minneapolis, MN 55402-2703 | 2020-07-26 |
| 1205444791 | Patrick Reilly Steck | Dentist | 4948 S 34th Ave, Minneapolis, MN 55417 | 2020-07-21 |
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| Find all providers with the same taxonomy | ||||
| City | SAINT MICHAEL |
| Zip Code | 55376 |
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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.