CRYSTAL LAKE FAMILY DENTAL CARE, PLLC (NPI# 1700058690) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700058690 |
| Entity Type | Organization |
| Organization Name | CRYSTAL LAKE FAMILY DENTAL CARE, PLLC |
| Other Organization Name | ORONO DENTAL CARE |
| Practice Address |
2765 Kelley Pkwy Ste 140 Orono MN 55356-5802 |
| Practice Telephone | 9524499494 |
| Practice Fax Number | 9524499499 |
| Mailing Telephone | 9524499494 |
| Mailing Fax Number | 9524499499 |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |
| Authorized Official Name | KARL BERG (OWNER) |
| Authorized Official Telephone | 9524499494 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
9161 | MN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Orono Dental Care | Doing Business As Name - Organization |
| Street Address |
2765 KELLEY PKWY STE 140 |
| City | ORONO |
| State | MN |
| Zip Code | 55356-5802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770658775 | Karl G Berg | Dentist | 2765 Kelley Pkwy Ste 140, Orono, MN 55356-5802 | 2006-11-22 |
| 1376716043 | Maple Plain Dental, Pllc | Dentist | 2765 Kelley Pkwy Ste 140, Orono, MN 55356-5802 | 2008-04-02 |
| 1184799181 | Michael J Skramstad | Dentist | 2765 Kelley Pkwy Ste 140, Orono, MN 55356-5802 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497136014 | Brianna B. Hammer | Dentist | 2765 Kelley Parkway, Suite 140, Orono, MN 55356 | 2015-06-10 |
| 1336279926 | Nicholas John Froehling | Chiropractor | 2060 West Wayzata Blvd, Suite 150, Orono, MN 55356 | 2007-03-06 |
| 1871654343 | Thomas Lee Sawyer Jr. | Psychologist | 3405 Co Rd 6, Orono, MN 55356 | 2006-12-12 |
| 1851470314 | Long Lake Assisted Living | Assisted Living Facility | 345 N Brown Rd, Long Lake, MN 55356 | 2006-11-03 |
| 1679678973 | Douglas John Mcnaught | Dentist | 1870 W. Wayzata Blvd., Long Lake, MN 55356 | 2006-09-13 |
| 1245690874 | Diane Pease | Massage Therapist | 2160 W Wayzata Blvd, Long Lake, MN 55356-1100 | 2016-02-24 |
| 1902341589 | Michael Joseph Sherman | Massage Therapist | 1865 W Wayzata Blvd Ste 200, Long Lake, MN 55356-4100 | 2017-01-05 |
| 1376584656 | Michael W. Schwartz | Chiropractor | 1865 W Wayzata Blvd, Ste 200, Long Lake, MN 55356-4100 | 2006-06-09 |
| 1871025031 | Chirocenter Inc. | Chiropractor | 1865 W Wayzata Blvd Ste 200, Long Lake, MN 55356-4100 | 2017-03-28 |
| 1255791745 | West Lake Counseling and Wellness, Inc | Social Worker | 1613 W Wayzata Blvd Ste B, Long Lake, MN 55356-4103 | 2016-02-26 |
| Find all providers in zip 55356 | ||||
| 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 |
|---|---|---|---|---|
| 1609432798 | Christina Mccullough Dds Pllc | Dentist | 2455 Shadywood Road, Orono, MN 55331 | 2019-05-14 |
| 1770658775 | Karl G Berg | Dentist | 2765 Kelley Pkwy Ste 140, Orono, MN 55356-5802 | 2006-11-22 |
| 1912925835 | G. J. Farren, Dmd, PC | Dentist | 379 College Ave, Orono, ME 04473-4213 | 2006-07-18 |
| 1376716043 | Maple Plain Dental, Pllc | Dentist | 2765 Kelley Pkwy Ste 140, Orono, MN 55356-5802 | 2008-04-02 |
| 1386857902 | Gary J Farren | Dentist | 379 College Ave, Orono, ME 04473-4213 | 2007-05-08 |
| 1184799181 | Michael J Skramstad | Dentist | 2765 Kelley Pkwy Ste 140, Orono, MN 55356-5802 | 2006-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001149 | Kalyan Chakravarthy Kondreddi | Dentist | 327 Western Ave Ste A, Fergus Falls, MN 56537-2403 | 2020-10-20 |
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1770190951 | Bluff Creek Dental Pllc | Dentist | 600 Market St Ste 130, Chanhassen, MN 55317-4570 | 2020-09-30 |
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1073128153 | Michael W Flinn Dds, Pa | Dentist | 200 Firewood Drive, Redwood, MN 56283 | 2020-09-15 |
| 1770196891 | Thomas J Hoeffel Dds Pa | Dentist | 2819 Hamline Ave N Ste 104, Roseville, MN 55113-7718 | 2020-08-28 |
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 1679182687 | Downtown Dental Center Pllc | Dentist | 825 Nicollet Mall Ste 1427, Minneapolis, MN 55402-2703 | 2020-07-26 |
| 1205444791 | Patrick Reilly Steck | Dentist | 4948 S 34th Ave, Minneapolis, MN 55417 | 2020-07-21 |
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| Find all providers with the same taxonomy | ||||
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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.