ENDODONTIC PROFESSIONALS PA - ST ANTHONY ENDODONTICS (NPI# 1538577341) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538577341 |
| Entity Type | Organization |
| Organization Name | ENDODONTIC PROFESSIONALS PA - ST ANTHONY ENDODONTICS |
| Practice Address |
3905 Silver Lake Rd Ne Minneapolis MN 55421-4352 |
| Mailing Address |
3401 Highway 169 N Plymouth MN 55441-2413 |
| Practice Telephone | 7635590859 |
| Practice Fax Number | 7635594356 |
| Mailing Telephone | 7635590859 |
| Mailing Fax Number | 7635594356 |
| Enumeration Date | 2014-07-24 |
| Last Update Date | 2014-07-24 |
| Authorized Official Name | DR. MARK R JENSEN (PRESIDENT) |
| Authorized Official Telephone | 7635590859 |
| Authorized Official Credential | DDS |
| 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 |
Dental Providers |
| Street Address |
3905 SILVER LAKE RD NE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55421-4352 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982241782 | Cc Group Home Care Inc | Non-emergency Medical Transport (VAN) | 524 Huset Pkwy Ne, Columbia Heights, MN 55421 | 2019-11-30 |
| 1710455324 | Victoria F Renner | Physical Therapist | 4512, 3700 Foss Rd, Minneapolis, MN 55421 | 2018-11-13 |
| 1245721976 | Complete Care Home Care LLC | Home Health | 4111 Central Ave Ne North Building, Suite 202, Columbia Heights, MN 55421 | 2018-05-29 |
| 1053816389 | Anoka Health Center LLC | Clinic/Center | 4111 Central Ave N.e, Suite 201 North Building, Columbia Heights, MN 55421 | 2018-03-28 |
| 1508381047 | Minnesota Home Health Care LLC | Home Health | 534 Huset Parkway, Columbia Heights, MN 55421 | 2017-08-05 |
| 1720520448 | Tesfa International School | Local Education Agency (LEA) | 1550 40th Avenue Northeast, Columbia Heights, MN 55421 | 2016-11-11 |
| 1487012548 | Icare Transportation | Non-emergency Medical Transport (VAN) | 2816 Silver Ln Ne #305, Saint Anthony, MN 55421 | 2016-02-04 |
| 1194183368 | Warsame Warsame | Non-emergency Medical Transport (VAN) | 1115 45th Ave Ne, Columbia Heights, MN 55421 | 2016-02-03 |
| 1083083398 | Epic Transportation LLC | Clinic/Center | 355 Orendorff Way Ne, Columbia Heights, MN 55421 | 2015-09-16 |
| 1508281023 | Alexandra Marie Hodson | Occupational Therapist | 5155 E. River Rd, Suite #403, Fridley, MN 55421 | 2014-02-20 |
| Find all providers in zip 55421 | ||||
| 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 |
|---|---|---|---|---|
| 1699268052 | Christopher Rex Lai | Dentist | 8-166 Moos Health Sciene Tower, 515 Delaware St. Se, Minneapolis, MN 55455 | 2018-06-11 |
| 1174638613 | Grace Ann Warren | Dentist | 4110 Cedar Ave S, Minneapolis, MN 55407-3433 | 2006-08-21 |
| 1407344278 | Hooi Pin Chew | Dentist | 516 Delaware St Se, 7th Floor Pwb, Minneapolis, MN 55455-0356 | 2018-04-27 |
| 1356791164 | Ronald Ordinola Zapata Sr. | Dentist | 515 Delaware St Se, Minneapolis, MN 55455 | 2016-06-13 |
| 1700269040 | Riley Lewis | Dentist | 515 Delaware St Se, Minneapolis, MN 55455-0357 | 2015-07-06 |
| 1548535180 | Walter Ray Bowles | Dentist | 515 Delaware St Se, 8-166 Moos Tower, Minneapolis, MN 55455-0357 | 2012-03-15 |
| 1821362005 | Michael Baisden | Dentist | 515 Delaware St Se, Minneapolis, MN 55455-0357 | 2012-03-06 |
| 1396948246 | Scott B. Mcclanahan | Dentist | 516 Delaware St Se, Faculty Practice Clinic, Minneapolis, MN 55455-0356 | 2007-06-07 |
| 1770664260 | Melissa Bagley Chapman | Dentist | 825 Nicollet Mall, Suite 911, Minneapolis, MN 55402-2606 | 2006-10-18 |
| 1558313973 | Cale S Strait | Dentist | 701 Park Ave, P7, Minneapolis, MN 55415-1623 | 2006-05-16 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55421 |
Please comment or provide details below to improve the information on ENDODONTIC PROFESSIONALS PA - ST ANTHONY ENDODONTICS.
| 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.