DR. MIKE R HENRICKSON (NPI# 1629291380) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629291380 |
| Entity Type | Individual |
| Full Name | DR. MIKE R HENRICKSON |
| Credential | DDS |
| Practice Address |
1560 Beam Ave Suite 2 Maplewood MN 55109-1191 |
| Practice Telephone | 6517778900 |
| Practice Fax Number | 6517778908 |
| Mailing Telephone | 6517778900 |
| Mailing Fax Number | 6517778908 |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D11920 | MN | Dental Providers |
| Street Address |
1560 BEAM AVE SUITE 2 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-1191 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710962188 | Mark W Erhard | Internal Medicine | 1560 Beam Ave, Suite B, Maplewood, MN 55109-1191 | 2005-12-08 |
| 1144602129 | Allina Health System | Internal Medicine | 1560 Beam Ave, Ste B, Maplewood, MN 55109-1191 | 2015-06-25 |
| 1215344742 | My Medical Clinic Pllc | Clinic/Center | 1560 Beam Ave, Maplewood, MN 55109-1191 | 2014-07-16 |
| 1720490279 | Kyle Danielson | Dentist | 1560 Beam Ave, Maplewood, MN 55109-1191 | 2014-06-02 |
| 1932343969 | Bhavana C Anand | Preventive Medicine | 1560 Beam Ave, Suite F, Maplewood, MN 55109 | 2009-04-21 |
| 1740444827 | Myron Henrickson, Dds Pa | Dentist | 1560 Beam Ave, Suite 2, Maplewood, MN 55109-1191 | 2008-07-17 |
| 1225247885 | Brandi Sue Meyer | Physical Therapy Assistant | 1560 Beam Ave, Maplewood, MN 55109-1191 | 2007-05-21 |
| 1992774970 | Paul Robert Duxbury | Physical Therapist | 1560 Beam Ave, Suite D, Maplewood, MN 55109-1171 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| 1235429267 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 1714 Cope Ave E, Maplewood, MN 55109-2664 | 2011-04-11 |
| 1295908994 | Alena Marie Harris Martens | Dentist | 1650 Beam Ave Ste 103, Maplewood, MN 55109-1147 | 2008-04-02 |
| 1235311614 | Community Dental Care Inc | Dentist | 1670 Beam Ave, Maplewood, MN 55109 | 2007-11-28 |
| 1891832648 | James V Galiano IIi | Dentist | 730 Prospect St, Maplewood, NJ 07040-3142 | 2007-01-31 |
| 1891848362 | Mary J. Pariseau | Dentist | 1975 11th Ave E, Maplewood, MN 55109-5148 | 2007-01-19 |
| 1003988809 | Kevin Francis Muench | Dentist | 140 Maplewood Avenue, Maplewood, NJ 07040 | 2006-11-15 |
| 1740398288 | Bruce C Haglund | Dentist | 1270 Cope Ave E, Maplewood, MN 55109 | 2006-08-25 |
| 1134160658 | April Marie Snyder | Dentist | 50 County Road B E, Maplewood, MN 55117-1927 | 2006-06-08 |
| 1710980180 | Gerard L. Gonsalves | Dentist | 2168 Millburn Ave, Ste 102, Maplewood, NJ 07040-2670 | 2005-05-31 |
| Find all providers in MAPLEWOOD | ||||
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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.