RIVER BLUFF DENTAL, P.A. (NPI# 1609098458) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609098458 |
| Entity Type | Organization |
| Organization Name | RIVER BLUFF DENTAL, P.A. |
| Practice Address |
10851 Rhode Island Ave S Bloomington MN 55438-2393 |
| Practice Telephone | 9528845361 |
| Practice Fax Number | 9529469533 |
| Mailing Telephone | 9528845361 |
| Mailing Fax Number | 9529469533 |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. WALTER PALMER (DENTIST & OWNER) |
| Authorized Official Telephone | 9528845361 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D10102 | MN | Dental Providers |
| Street Address |
10851 RHODE ISLAND AVE S |
| City | BLOOMINGTON |
| State | MN |
| Zip Code | 55438-2393 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639136740 | Gregory Richard White | Dentist | 10851 Rhode Island Ave S, Bloomington, MN 55438-2393 | 2006-05-01 |
| 1083783831 | Kenneth Alyn Kokkinen | Dentist | 10851 Rhode Island Ave S, Bloomington, MN 55438-2393 | 2006-11-07 |
| 1821167669 | Walter James Palmer | Dentist | 10851 Rhode Island Ave S, Bloomington, MN 55438-2393 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912425570 | Angela Marie Gilbert | Registered Nurse | 10700 Brunswick Rd Unit 316, Bloomington, MN 55438 | 2017-09-05 |
| 1609905686 | Marypat Habermas | Pharmacist | 7349 Bush Lake Dr, Bloomington, MN 55438 | 2007-03-05 |
| 1629564620 | Andrea Jean Hegland | Pharmacist | One Veterans Drive, Pharmacy Service (119), Minneapolis, MN 55438 | 2018-07-03 |
| 1861050197 | Dustin James Javers | Physical Therapist | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2019-06-01 |
| 1285156240 | Dawn Marie Johnson | Occupational Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2017-07-12 |
| 1154777654 | Jennifer Bean | Occupational Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2016-05-13 |
| 1831588250 | Sia Bacas Langum | Occupational Therapist | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2015-01-22 |
| 1073948576 | Kathleen Ann Linnan Rudgers | Physical Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2013-09-04 |
| 1508201211 | Barbara Ann Spleiss | Occupational Therapy Assistant | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2013-05-08 |
| 1194160895 | Patty Norby | Physical Therapist | 8100 Highwood Dr, Bloomington, MN 55438-1006 | 2013-05-08 |
| Find all providers in zip 55438 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962026948 | Maria Contreras Mantilla | Dentist | 1320 W Bloomfield Rd, Bloomington, IN 47403-2001 | 2020-06-04 |
| 1144703026 | Aneetam Bassi | Dentist | 3609 General Electric Rd Ste A, Bloomington, IL 61704-8766 | 2018-09-07 |
| 1467934505 | Mary Therese Block | Dentist | 2507 E Poplar Dr, Bloomington, IN 47401-4327 | 2018-09-05 |
| 1619456373 | Applewhite Dental Illinois, P.C. | Dentist | 2103 E Washington St Ste 1c, Bloomington, IL 61701-4365 | 2018-08-13 |
| 1154842581 | Anna Noel Nord | Dentist | 1404 Eastland Dr Ste 102, Bloomington, IL 61701-7904 | 2017-07-06 |
| 1528416302 | Nathaniel Gonzales | Dentist | 10700 France Ave S Ste 102, Bloomington, MN 55431-3693 | 2016-06-02 |
| 1902251911 | Optim Dental Bloomington LLC | Dentist | 401 N Veterans Pkwy Ste 4, Bloomington, IL 61704-7716 | 2016-04-27 |
| 1194181560 | Sleep Solutions of Central Illinois | Dentist | 2309 E. Empire St, Suite 500, Bloomington, IL 61704-8900 | 2016-01-14 |
| 1619353521 | Courtney Morgan | Dentist | 2306 Stern Dr, Bloomington, IL 61704-4406 | 2015-08-03 |
| 1508240763 | Marisa Lee Milligan | Dentist | 1404 Eastland Dr Ste 101, Bloomington, IL 61701-7904 | 2015-07-16 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 55438 |
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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.