BRAINERD DENTAL CLINIC (NPI# 1467508226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467508226 |
| Entity Type | Organization |
| Organization Name | BRAINERD DENTAL CLINIC |
| Practice Address |
11800 State Ave Brainerd MN 56401-7308 |
| Mailing Address |
Po Box 64979 Saint Paul MN 55164-0979 |
| Practice Telephone | 2188282201 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2009-02-27 |
| Authorized Official Name | MR. ROD L. KORNRUMPF (ADULT MENTAL HEALTH ADMINISTRATOR) |
| Authorized Official Telephone | 6514315003 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223D0001X |
Dentist Specialization: Dental Public Health |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 970826000 | 05 |
| Street Address |
11800 STATE AVE |
| City | BRAINERD |
| State | MN |
| Zip Code | 56401-7308 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841206901 | Susan Mary Mathison-young | Nurse Practitioner | 11800 State Ave, Brainerd, MN 56401-7308 | 2006-07-31 |
| 1659434744 | Susan K Dudding | Nurse Practitioner | 11800 State Ave, Brainerd, MN 56401-7308 | 2006-12-19 |
| 1679648414 | John Phillip Koop | Pharmacist | 11800 State Ave, Brainerd, MN 56401-7308 | 2006-11-21 |
| 1659445229 | C.a.r.e.-brainerd | Substance Abuse Rehabilitation Facility | 11800 State Ave, Brainerd, MN 56401-7308 | 2006-11-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396222832 | Nicholas James Manning | Physical Therapist | 7350 Clearwater Rd N, Baxter, MN 56401 | 2018-07-27 |
| 1952819757 | Hannah Marie Darabi | Physical Therapist | Essentia Health Rehabilitation Services, 2016 South Sixth Street, Brainer, MN 56401 | 2018-01-15 |
| 1154867406 | Nancy Ann Schauer | Social Worker | 823 Maple Street, Northern Pine Mental Health Center, Brainerd, MN 56401 | 2017-01-10 |
| 1336530310 | Audrey Jean Twit | Pharmacist | 523 North Third Street, Essentia Health St Joseph's Medical Center, Brainerd, MN 56401 | 2015-02-11 |
| 1245638584 | The Renneke Chiropractic Clinic | Physical Therapist | 623 Madison St., Brainerd, MN 56401 | 2014-12-19 |
| 1124420179 | Jenna Niggeler | Acupuncturist | 1001 Kingwood St Ste 119a, Brainerd, MN 56401 | 2014-09-22 |
| 1073933719 | Nicholas Adam Lesmeister | Orthopaedic Surgery | 2014 South 6th Street, Brainerd, MN 56401 | 2014-04-21 |
| 1073864666 | Jennifer L. Owens | Marriage & Family Therapist | 4706 Wilderness Ct Ste 101, Brainerd, MN 56401 | 2012-09-24 |
| 1619297447 | Christine Elaine Smalling | Licensed Practical Nurse | 6317 Estate Circle Drive, Brainerd, MN 56401 | 2010-06-03 |
| 1528241577 | Dannia Lor Vang | Pharmacist | 2024 South 6th St, Clinic Pharmacy, Brainerd, MN 56401 | 2007-12-13 |
| Find all providers in zip 56401 | ||||
| Taxonomy Code | 1223D0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Dental Public Health |
| The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice that serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076073 | Rae Ann Ann Swanson | Dentist | 755 Florida Ave S, Minneapolis, MN 55426-1784 | 2020-09-02 |
| 1083178149 | Lift Dental Pllc | Dentist | 124 2nd St S Ste 101, Stillwater, MN 55082-5179 | 2019-01-23 |
| 1669842662 | Children's Dental Services | Dentist | 229 W Lake St, Chisholm, MN 55719 | 2015-10-02 |
| 1407224827 | Children's Dental Services | Dentist | 325 N Sibley Ave, Litchfield, MN 55355-2150 | 2015-09-02 |
| 1194095778 | Matthew Allen Olson | Dentist | 715 11th St N Ste 106b, Moorhead, MN 56560-2000 | 2012-01-12 |
| 1801118039 | Omar Dyab Dds Pa | Dentist | 13590 Northdale Blvd, Suite 300, Rogers, MN 55374-2150 | 2010-02-15 |
| 1407973605 | Childrens Dental Services Inc | Dentist | 636 Broadway St. Ne, Minneapolis, MN 55413 | 2007-03-23 |
| 1437287679 | Mississippi Headwaters Area Dental Health Center, Inc. | Dentist | 616 America Ave Nw Ste 340, Attention Mary Marchell, Bemidji, MN 56601-3871 | 2007-03-01 |
| 1205991866 | Fergus Falls Dental Group | Dentist | 1121 Pebble Lake Rd, Fergus Falls, MN 56537 | 2006-12-26 |
| 1437238052 | Tracey Roseann Charles | Dentist | 9345 Calypso Trail Nw, Bemidji, MN 56601 | 2006-11-03 |
| 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.