DR. BETH ANN GAVREN (NPI# 1699764431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699764431 |
| Entity Type | Individual |
| Full Name | DR. BETH ANN GAVREN |
| Credential | DDS |
| Practice Address |
15785 95th Ave N Maple Grove MN 55369-4404 |
| Practice Telephone | 7632334141 |
| Practice Fax Number | 7634205875 |
| Mailing Telephone | 7632334141 |
| Mailing Fax Number | 7634205875 |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2013-06-28 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D11463 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 8068330-00 | 05 |
| Street Address |
15785 95TH AVE N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55369-4404 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780010025 | Christopher Michael Rae | Dentist | 15785 95th Ave N, Maple Grove, MN 55369 | 2013-09-18 |
| 1992934418 | Katie Kickertz | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2009-07-06 |
| 1043467293 | Northland Dental Partners Pllc | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2008-08-19 |
| 1730390063 | Christina Marie Mccullough | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2007-05-25 |
| 1801959242 | Kristine Carol Rosenthal | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-18 |
| 1528120557 | Noah Andrew Rounds | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-15 |
| 1629137054 | Kelly Kristine Mehta | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-08 |
| 1942369749 | Kyle Patrick Gearhart | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-07 |
| 1023177011 | James Michael Healy | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-12-06 |
| 1275649394 | Mitchell Lee Page | Dentist | 15785 95th Ave N, Maple Grove, MN 55369-4404 | 2006-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144188 | Bonnie Rose Theis | Counselor | 24 3rd Ave Ne, Unit B, Osseo, MN 55369 | 2020-11-06 |
| 1356976328 | Kirollos Samir Hanna | Pharmacist | 14500 99th Ave N, Suite 0a030, Maple Grove, MN 55369 | 2020-03-10 |
| 1396395463 | Susan Osborne | Technician | 9240 Orchid Lane, Maple Grove, MN 55369 | 2019-09-19 |
| 1710537196 | Janis Langsdale | Technician | 11070 108 Avenue North, Maple Grove, MN 55369 | 2019-09-17 |
| 1043724552 | Tracey Wahlquist | Speech-Language Pathologist | 11100 86th Ave N, Maple Grove, MN 55369 | 2017-11-20 |
| 1154860005 | Kayla Uptagrafft | Specialist/Technologist | 9555 Upland Lane Norh, Maple Grove, MN 55369 | 2017-02-13 |
| 1750823324 | Jennifer Ranallo | Social Worker | 9600 Upland Ln N Ste 110, Maple Grove, MN 55369 | 2016-11-13 |
| 1558723999 | Debra Grace Boersma | Advanced Practice Midwife | 9825 Hospital Dr#205, Maple Grove, MN 55369 | 2016-03-24 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1558755900 | Krista Newman | Counselor | 24 3rd St Nw, Unit B, Osseo, MN 55369 | 2015-03-24 |
| Find all providers in zip 55369 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902917057 | Oral & Maxillofacial Surgery Specialists, Pa | Dentist | 13784 83rd Way N Ste 92, Maple Grove, MN 55369-7191 | 2006-08-31 |
| 1912143843 | Dental Specialists of Minnesota, Pllc | Dentist | 9325 Upland Ln N, Suite 330, Maple Grove, MN 55369-4200 | 2008-12-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1285294611 | Brian Michael Laing | Dentist | 7-147 Moos Health Science Tower, 515 Delaware Street S.e., Minneapolis, MN 55455-0357 | 2019-06-18 |
| 1295218303 | Advanced Oral Surgery | Dentist | 19925 Idealic Ave, Lakeville, MN 55044-2003 | 2018-09-13 |
| 1205366002 | Derek Miller | Dentist | 7-174 Moos Tower 515 Delaware St. S, U of M Oral Surgery, Minneapolis, MN 55455 | 2017-06-14 |
| 1497113674 | West Lakes Dentistry, Pa | Dentist | 5205 Shoreline Dr, Mound, MN 55364-1770 | 2016-02-03 |
| 1003203498 | Tyler John Varhol | Dentist | 550 County Road D W Ste 12, New Brighton, MN 55112-3517 | 2015-04-23 |
| 1225458391 | Levi Zarbano | Dentist | 2550 University Ave W Ste 115n, Saint Paul, MN 55114-1097 | 2014-04-16 |
| 1154760932 | John Salek-raham | Dentist | 700 Village Center Dr., Ste 170, North Oaks, MN 55127-3025 | 2013-06-14 |
| 1649511585 | Kristopher Lee Hasstedt | Dentist | Dentists of Woodbury, 7150 Valley Creek Plaza Ste #230, Woodbury, MN 55125 | 2013-03-01 |
| 1396095048 | Dental Specialists of Minnesota, Pllc | Dentist | 3360 Northdale Blvd., Coon Rapids, MN 55448-1825 | 2012-09-10 |
| Find all providers with the same taxonomy | ||||
| City | MAPLE GROVE |
| Zip Code | 55369 |
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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.