ENDODONTIC PROFESSIONALS PA ST CLOUD ENDODONTICS (NPI# 1487847752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487847752 |
| Entity Type | Organization |
| Organization Name | ENDODONTIC PROFESSIONALS PA ST CLOUD ENDODONTICS |
| Practice Address |
1555 Northway Drive Suite 210 St Cloud MN 56303 |
| Practice Telephone | 3202595078 |
| Practice Fax Number | 3202591484 |
| Mailing Telephone | 3202595078 |
| Mailing Fax Number | 3202591484 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2007-08-21 |
| Authorized Official Name | THOMAS A KARN (VICE PRESIDENT) |
| Authorized Official Telephone | 3202595078 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | Y |
| Parent Organization Name | ENDODONTIC PROFESSIONALS PA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
8575456 | MN | Dental Providers |
| Street Address |
1555 NORTHWAY DRIVE SUITE 210 |
| City | ST CLOUD |
| State | MN |
| Zip Code | 56303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881696490 | Centracare Clinic | Durable Medical Equipment & Medical Supplies | 1555 Northway Drive, St Cloud, MN 56303 | 2005-08-12 |
| 1891077475 | Nicole Ann Ouke | Nurse Practitioner | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2011-09-09 |
| 1366580136 | Jimmie Lewis Browning | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2007-02-02 |
| 1508885013 | Dennis L Peterson | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-07-18 |
| 1285660548 | Kevin R Switzer | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-06-25 |
| 1326097882 | Paul M Wenner | Psychologist | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-05-10 |
| 1770532426 | St. Cloud Hospital | Clinic/Center | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-05-09 |
| 1316915325 | Joseph M Blonski | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-03-08 |
| 1851369862 | Thomas John Satre | Family Medicine | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-03-08 |
| 1013984491 | Penny L Rubesh | Nurse Practitioner | 1555 Northway Drive, Suite 200, St Cloud, MN 56303-4913 | 2006-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071199 | Dental Specialist of Minnesota, Pllc | Dentist | 18258 Minnetonka Blvd Ste 100, Wayzata, MN 55391-3324 | 2020-07-29 |
| 1215588660 | The Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2019-09-26 |
| 1780236539 | Modern Care Endodontics of Apple Valley | Dentist | 15160 Foliage Ave Ste 100, Apple Valley, MN 55124-5916 | 2019-07-11 |
| 1699268052 | Christopher Rex Lai | Dentist | 8-166 Moos Health Sciene Tower, 515 Delaware St. Se, Minneapolis, MN 55455 | 2018-06-11 |
| 1699272427 | Group Health Plan Inc | Dentist | 5500 Excelsior Blvd, St Louis Park, MN 55416-2935 | 2018-04-09 |
| 1225533037 | Younghyup Byun | Dentist | 1900 Kruchten Ct S Ste 100, Sartell, MN 56377-4731 | 2018-03-26 |
| 1275034886 | Great River Endodontics | Dentist | 9381 Cedar St., Monticello, MN 55362 | 2018-02-28 |
| 1417464157 | Deer River Dental Clinic | Dentist | 111 Main Street E, Deer River, MN 56636 | 2018-01-03 |
| 1174045975 | The Dental Specialists of Minnesota, Pllc | Dentist | 4640 Nicols Rd Ste 202, Eagan, MN 55122-7400 | 2017-07-13 |
| 1861914061 | The Dental Specialist of Minnesota, Pllc | Dentist | 2550 University Ave W Ste 155s, Saint Paul, MN 55114-1098 | 2017-07-10 |
| 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.