AMBER NICHELLE IRBY (NPI# 1487264446) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487264446 |
Entity Type | Individual |
Full Name | AMBER NICHELLE IRBY |
Credential | MDT |
Practice Address |
903 W Center St #130 Rochester MN 55902 |
Mailing Address |
3035 Brittany Ln Nw Apt C Rochester MN 55901-7012 |
Practice Telephone | 5075290436 |
Practice Fax Number | 5075290435 |
Mailing Telephone | 7572188082 |
Enumeration Date | 2020-08-05 |
Last Update Date | 2020-08-05 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 125J00000X | Dental Therapist | DT129 | MN | Dental Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NA | NA | 01 |
Street Address |
903 W CENTER ST #130 |
City | ROCHESTER |
State | MN |
Zip Code | 55902 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720584337 | John E Herman Home and Treatment Facility, LLC | Psychiatric Residential Treatment Facility | 351 14th Ave Sw, Rochester, MN 55902 | 2018-04-03 |
1912442898 | Esperanza Torres | Dental Hygienist | 903 West Center Street, Suite 130, United Way Bldg, Rochester, MN 55902 | 2016-12-30 |
1578971149 | Alduz Inri Surio Cabasa | Student in an Organized Health Care Education/Training Program | 609 1st Street Sw, Unit 102, Rochester, MN 55902 | 2014-07-28 |
1679901854 | Julie Erickson | Dental Hygienist | United Way Building Suite #208, Rochester, MN 55902 | 2013-10-24 |
1619313590 | Mercedes K Schulz | Dental Hygienist | 13394th Ave Sw, Rochester, MN 55902 | 2013-05-17 |
1093087389 | Sarah Jean Dennison | Clinic/Center | 930 West Center Street, Suite 208 United Way Bldg, Rochester, MN 55902 | 2012-02-01 |
1467732156 | Angela Elizabeth Peters | Registered Nurse | 1450 2nd Avenue Sw, Rochester, MN 55902 | 2011-08-25 |
1528350071 | Emily Zahasky Kraft | Pharmacist | 204 1st Street Sw, Rochester, MN 55902 | 2011-05-03 |
1093021982 | Sherry Dawn Boutcher | Dental Hygienist | 903 West Center Street Suite 208, United Way Building, Rochester, MN 55902 | 2010-08-30 |
1811208424 | Grant Conrad Collins | Dentist | 1340 Salem Rd Sw, Rochester, MN 55902 | 2010-06-29 |
Find all providers in zip 55902 |
Taxonomy Code | 125J00000X |
Grouping | Dental Providers |
Classification | Dental Therapist |
A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. |
Notes: Source: Summarized from Minnesota Statute 150A.105. [7/1/2012: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1770072167 | Stefanie Faye Tessling | Dental Therapist | 973 Skyline Dr Sw, Rochester, MN 55902-1220 | 2018-05-01 |
1285130799 | Molly Matusiewicz | Dental Therapist | 3000 43rd St Nw, Rochester, MN 55901-5847 | 2018-04-03 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558835942 | Jennifer Iacobelli | Dental Therapist | 13899 Highway 13 South Frontage Road, Savage, MN 55378 | 2019-01-18 |
1992288781 | Katie Ask | Dental Therapist | 13889 Highway 13 S, Frontage Rd, Savage, MN 55378 | 2018-09-08 |
1487154092 | Sunny Moon | Dental Therapist | 10584 France Ave S, Bloomington, MN 55431-3538 | 2018-02-20 |
1326548454 | Julie Bonham | Dental Therapist | 803 3rd St. Se, Suite 330, Little Falls, MN 56345 | 2018-02-15 |
1376077974 | Saritha Gajawada | Dental Therapist | 15354 Plumstone Dr, Eden Prairie, MN 55347-2061 | 2017-04-20 |
1649644063 | Brittany Gronland | Dental Therapist | 25730 Smithtown Rd, Excelsior, MN 55331-8592 | 2015-11-23 |
1124405857 | Jenna Susanne Marquardt | Dental Therapist | 209 South 1st Street, Montevideo, MN 56265 | 2015-05-01 |
1558751495 | Weston Mark Schmidt | Dental Therapist | 411 East Howard St., Jacobson Family Dentistry PC, Hibbing, MN 55746 | 2015-01-30 |
1003230137 | Janelle Jehn | Dental Therapist | 4342 4th Ave S, Minneapolis, MN 55409-2155 | 2014-02-10 |
1346506011 | Lindsey Lee Tischer | Dental Therapist | 205 Pleasant Ave, Park Rapids, MN 56470-1432 | 2012-04-07 |
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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.