CENTENNIAL LAKES ORTHODONTICS PLLC (NPI# 1457979031) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457979031 |
| Entity Type | Organization |
| Organization Name | CENTENNIAL LAKES ORTHODONTICS PLLC |
| Practice Address |
7373 France Ave S Ste 400 Edina MN 55435-4549 |
| Practice Telephone | 9528311324 |
| Mailing Telephone | 9528311324 |
| Enumeration Date | 2020-07-09 |
| Last Update Date | 2020-07-09 |
| Authorized Official Name | STEPHEN COLBY (OWNER) |
| Authorized Official Telephone | 9528311324 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Street Address |
7373 FRANCE AVE S STE 400 |
| City | EDINA |
| State | MN |
| Zip Code | 55435-4549 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710367925 | Lindsay Bedeaux | Dentist | 7373 France Ave S Ste 400, Edina, MN 55435-4549 | 2015-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104433416 | Evy Christine Claussen | Social Worker | 6363 France Ave. S., Edina, MN 55435 | 2020-09-30 |
| 1508496621 | Samantha Jean Mcgough Lamere | Physician Assistant | 4300 Marketpointe Drive, Suite 100, Bloomington, MN 55435 | 2020-01-16 |
| 1659920460 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 3408 Galleria, Edina, MN 55435 | 2019-09-05 |
| 1730651639 | Taylor Lee Kehoe | Physician Assistant | 7400 France Ave., Suite #100, Edina, MN 55435 | 2018-12-18 |
| 1538666326 | Amanda Deangelo | Physical Therapist | 6401 Southdale Hospital, Ll3g, Edina, MN 55435 | 2018-04-09 |
| 1982107876 | Julia Seliber | Dental Hygienist | 7600 France Ave.s. Suite 1100, Edina, MN 55435 | 2018-03-16 |
| 1154840064 | Southhealth Asc, LLC | Clinic/Center | 4100 Minnesota Drive, Edina, MN 55435 | 2017-09-12 |
| 1730605528 | Edina Medical Supplies | Durable Medical Equipment & Medical Supplies | 7455 France Ave., #614 S, Edina, MN 55435 | 2017-08-14 |
| 1033565510 | Minnesota Disc Replacement and Spine Restoration Center | Clinic/Center | 4444 76 St, #700, Edina, MN 55435 | 2016-05-13 |
| 1306206321 | Barb Ryan | Mechanotherapist | 7550 France Avenue S, #220, Edina, MN 55435 | 2016-03-03 |
| Find all providers in zip 55435 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669894887 | Orthodontic Care Specialists, Pllc | Dentist | 4980 W. 77th St., Edina, MN 55436 | 2014-01-07 |
| 1871837708 | Dentalign, P.a | Dentist | 4630 Edgebrook Pl, Edina, MN 55424-1152 | 2012-11-15 |
| 1447506571 | Gerald D. Cavanaugh & William F. Liljemark | Dentist | 3939 W. 50th St, Suite #207, Edina, MN 55424-1258 | 2012-07-26 |
| 1356586804 | Stanley P. Williamson, D.d.s., P.a. | Dentist | 5101 Vernon Ave S Ste 502, Edina, MN 55436-2169 | 2008-12-12 |
| 1649424904 | Minnesota Orthodontics and Dentofacial Orthopedics Pa | Dentist | 7149 France Ave S, Edina, MN 55435-4304 | 2008-11-12 |
| 1215157631 | Gary Alan Bolmgren | Dentist | 381 Southdale Medical Center, 6545 France Ave. S., Edina, MN 55435-2121 | 2007-04-26 |
| 1477658359 | Scott Robert Bowlby | Dentist | 3939 W 50th St Ste 207, Edina, MN 55424-1258 | 2006-09-14 |
| 1124120415 | William B Colby | Dentist | 7373 France Ave S Ste 504, Edina, MN 55435-4549 | 2006-09-05 |
| 1396089298 | Pan Orthodontic Clinics | Dentist | 5101 Vernon Ave S, Suite 502, Edina, MN 55436-2172 | 2012-11-15 |
| 1821345968 | Yu Pan | Dentist | 5101 Vernon Ave S, Suite 502, Edina, MN 55436-2172 | 2012-08-08 |
| Find all providers in EDINA | ||||
Please comment or provide details below to improve the information on CENTENNIAL LAKES ORTHODONTICS PLLC.
| 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.