DR. MASSIMO COSTALONGA (NPI# 1649563040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649563040 |
| Entity Type | Individual |
| Full Name | DR. MASSIMO COSTALONGA |
| Credential | D.M.D., PH.D. |
| Practice Address |
516 Delaware St Se 7-300 Pwb Minneapolis MN 55455-0356 |
| Mailing Address |
515 Delaware St Se 7-368 Moost Minneapolis MN 55455-0357 |
| Practice Telephone | 6126263233 |
| Enumeration Date | 2011-05-18 |
| Last Update Date | 2011-05-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
D11846 | MN | Dental Providers |
| Street Address |
516 DELAWARE ST SE 7-300 PWB |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55455-0356 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912990060 | Anthony J Santiago | Psychiatry & Neurology | 516 Delaware St Se, Clinic 1a, Minneapolis, MN 55455-0356 | 2005-08-24 |
| 1225592249 | Thomas Bukowski | Registered Nurse | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2019-01-23 |
| 1407344278 | Hooi Pin Chew | Dentist | 516 Delaware St Se, 7th Floor Pwb, Minneapolis, MN 55455-0356 | 2018-04-27 |
| 1093223786 | Mai E Lor | Technician/Technologist | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2018-01-16 |
| 1063866820 | Kelsey Noah | Occupational Therapist | 516 Delaware St Se, Mmc106, Minneapolis, MN 55455-0356 | 2016-04-19 |
| 1467811125 | Kristin Schneller | Occupational Therapist | 516 Delaware St Se, Mmc106, Minneapolis, MN 55455-0356 | 2016-02-23 |
| 1013382472 | Brooke Kaney | Social Worker | 516 Delaware St Se, Clinic 1c, Minneapolis, MN 55455-0356 | 2015-12-09 |
| 1447632682 | Christian Larson | Optometrist | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2015-06-24 |
| 1770970485 | Sarah Maki | Internal Medicine | 516 Delaware St Se, Minneapolis, MN 55455 | 2015-04-20 |
| 1235525627 | Shanon Renee Harper | Nurse Practitioner | 516 Delaware St Se, Minneapolis, MN 55455-0356 | 2015-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1952922148 | Jacob Laurence Tigner | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-29 |
| 1710507538 | Rachael Grundman | Student in an Organized Health Care Education/Training Program | 420 Delaware St, Mmc 395, Minneapolis, MN 55455 | 2020-04-22 |
| 1497375240 | Sanjay Dhawan | Student in an Organized Health Care Education/Training Program | 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 | 2020-04-22 |
| 1508486549 | Dariel Andres Diaz | Student in an Organized Health Care Education/Training Program | 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 | 2020-04-20 |
| 1275186280 | Kerem Ozturk | Radiology | B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 | 2019-07-18 |
| 1275194631 | Andres Jose Gonzalez Coba | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 | 2019-06-26 |
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1932767399 | Claire-audrey Y Bayan | Student in an Organized Health Care Education/Training Program | 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 | 2019-05-31 |
| Find all providers in zip 55455 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316400591 | Shorouk Elnagdy | Dentist | 515 Delaware St Se # 7-368, Minneapolis, MN 55455-0357 | 2019-04-13 |
| 1861784050 | Elham Akhlaghi | Dentist | 515 Delaware Street, Minneapolis, MN 55455 | 2011-05-06 |
| 1972770006 | Ying-lien Wu | Dentist | 150 S 5th St Ste 1475, Minneapolis, MN 55402-4212 | 2008-05-08 |
| 1417020017 | Glenn I Lepor | Dentist | 3909 Silver Lake Rd Ne, Minneapolis, MN 55421-4352 | 2006-11-15 |
| 1548756984 | Barbara Botorous | Dentist | 515 Delaware St Se, Minneapolis, MN 55455-0357 | 2018-07-09 |
| 1851884712 | Alessandro Pedercini | Dentist | 515 Delaware Street Se, 7-368 Moos Health Science Tower, Minneapolis, MN 55455 | 2018-06-14 |
| 1679904429 | Ryan Wolff | Dentist | 515 Delaware St Se, 7-360 Moos Tower, Minneapolis, MN 55455-0357 | 2013-12-04 |
| 1417213695 | Sofia Karadimitriou | Dentist | 515 Delaware St Se, School of Dentistry, Minneapolis, MN 55455-0357 | 2012-04-02 |
| 1245506849 | Bashar Bakdash | Dentist | 515 Delaware St Se, 7-368 Mhst, Minneapolis, MN 55455-0357 | 2012-03-28 |
| 1588996821 | Andrea Hsu | Dentist | 515 Delaware St Se, 7-368 Moos Health Science Tower, Minneapolis, MN 55455-0357 | 2010-02-11 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55455 |
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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.