MR. MIKE N MISKOVICH


Address: 1121 Se 4th Avenue, Grand Rapids, MN 55744
Phone: 2183263437

MR. MIKE N MISKOVICH (NPI# 1609941863) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1609941863
Entity Type Individual
Full Name MR. MIKE N MISKOVICH
Credential DDS
Practice Address 1121 Se 4th Avenue
Grand Rapids
MN 55744
Practice Telephone 2183263437
Practice Fax Number 2183271211
Mailing Telephone 2183263437
Mailing Fax Number 2183271211
Enumeration Date 2006-11-22
Last Update Date 2007-07-08
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
8313 MN Dental Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN BLUE CROSS BLUE SH MN 72417MI 01
UNITED CONCORDIA 85154 01

Office Location

Street Address 1121 SE 4TH AVENUE
City GRAND RAPIDS
State MN
Zip Code 55744

Providers in the same location

NPI Name Taxonomy Address Enumeration
1255407060 Miskovich Dental Clinic Dentist 1121 Se 4th Avenue, Grand Rapids, MN 55744 2006-11-27
1780759944 Peter J Miskovich Dentist 1121 Se 4th Avenue, Grand Rapids, MN 55744 2006-11-22

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1710587696 Friesen & Friesen, Inc Assisted Living Facility 1971 Ne 1st Avenue, Grand Rapids, MN 55744 2020-10-29
1699392555 Duane Stanley Helmer Counselor First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 2020-06-26
1821631391 Patrice Marie Curtiss Technician 23792 Winckler Road, Grand Rapids, MN 55744 2019-10-28
1578117438 Christina Marie Hubred Advanced Practice Dental Therapist Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 2019-07-30
1780081877 Fcsl Grand Rapids, LLC Assisted Living Facility 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 2014-12-04
1912311333 Doctor V LLC Psychologist 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 2014-06-13
1104244987 Linda Reinen-thompson Contractor 34307 Hwy. 38, Grand Rapids, MN 55744 2014-03-31
1275883266 Lana Rae Jacobson Registered Nurse 1401 Nw 9th Street, Grand Rapids, MN 55744 2012-09-17
1518252048 David Allen Griggs Pharmacist 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 2011-06-13
1447575063 Kelly Ann Shermoen Pharmacist 18 Se 10th Street, Grand Rapids, MN 55744 2010-04-07
Find all providers in zip 55744

Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Notes: Source: Academy of General Dentistry

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265059570 Samuel T. Bander, Dds, Plc Dentist 1151 E Paris Ave Se Ste 100, Grand Rapids, MI 49546-8369 2020-07-02
1295360428 Dj Edgerle, Dds, PC Dentist 751 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546-2391 2020-03-09
1639638265 Mark E Peterson, Dds Dentist 2440 Gaynor Ave Nw, Grand Rapids, MI 49544-1830 2019-03-13
1811463730 Ryan C. Van Haren, Dds Pllc Dentist 2144 E Paris Ave Se Ste 110, Grand Rapids, MI 49546-6111 2018-10-18
1386138881 Jayson Lynn Clore Dentist 334 68th St Sw, Grand Rapids, MI 49548-7179 2018-06-18
1154788230 Kb Family Dentistry Plc Dentist 3167 Kalamazoo Ave Se # 1, Grand Rapids, MI 49508-1475 2016-01-21
1821471616 Healthy Smile Plc Dentist 2021 44th St Sw, Grand Rapids, MI 49508 2015-06-30
1841694387 Jerry B. Mulder Dds Plc Dentist 515 Michigan St Ne Ste 202, Grand Rapids, MI 49503-5721 2014-10-13
1609277854 Alexis Neuman Dentist 3930 Burton St Se, Grand Rapids, MI 49546-5819 2014-09-08
1124439476 Bryton Mansfield Dentist 1636 Leonard St Nw, Grand Rapids, MI 49504-3950 2014-05-08
Find all providers in GRAND RAPIDS

Competitor

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City GRAND RAPIDS
Zip Code 55744

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Dataset Information

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.

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