DR. PATRICK JOSEPH ENNEN (NPI# 1710944988) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710944988 |
| Entity Type | Individual |
| Full Name | DR. PATRICK JOSEPH ENNEN |
| Credential | DDS |
| Practice Address |
3960 Coon Rapids Blvd Nw Suite 213 Coon Rapids MN 55433-2569 |
| Practice Telephone | 7634274912 |
| Practice Fax Number | 7634270771 |
| Mailing Telephone | 7634274912 |
| Mailing Fax Number | 7634270771 |
| Enumeration Date | 2006-04-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
7668 | MN | Dental Providers |
| Street Address |
3960 COON RAPIDS BLVD NW SUITE 213 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-2569 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740275833 | Byron A Teska | Ophthalmology | 3960 Coon Rapids Blvd Nw, Suite 304, Coon Rapids, MN 55433-2569 | 2005-09-14 |
| 1689068462 | Group Health Plan, Inc. | Clinic/Center | 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433 | 2015-03-19 |
| 1770829939 | Handi Medical Supply, Inc. | Durable Medical Equipment & Medical Supplies | 3960 Coon Rapids Blvd Nw, Ste #102, Coon Rapids, MN 55433-2521 | 2012-12-17 |
| 1245510700 | Lesley Rae Kurowski | Nurse Practitioner | 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433-2569 | 2011-08-27 |
| 1629387303 | Minnesota Oncology Hematology Pa | Clinic/Center | 3960 Coon Rapids Blvd Nw, # 311, Coon Rapids, MN 55433-2569 | 2010-09-29 |
| 1558696526 | Kimberly F Laxmana | Nurse Practitioner | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2009-10-08 |
| 1326276627 | Katherine Wolf Gurchak | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2009-06-24 |
| 1679715601 | Patricia Ann Harper | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2009-04-06 |
| 1447409834 | Minnesota Oncology Hematology, Pa | Obstetrics & Gynecology | 3960 Coon Rapids Blvd Nw, Suite 101, Coon Rapids, MN 55433-2569 | 2008-09-10 |
| 1528256062 | Carmen J Schroeder | Nurse Practitioner | 3960 Coon Rapids Blvd Nw, Suite 311, Coon Rapids, MN 55433-2569 | 2007-10-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1760596308 | Richard Brian Wittenberg | Dentist | 13055 Riverdale Dr Nw, Suite 400, Coon Rapids, MN 55448-8403 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316400591 | Shorouk Elnagdy | Dentist | 515 Delaware St Se # 7-368, Minneapolis, MN 55455-0357 | 2019-04-13 |
| 1508300252 | Minnesota Periodontal Associates, Pa | Dentist | 4801 Hwy 61 N., Suite 300, White Bear Lake, MN 55110-2753 | 2016-12-15 |
| 1164978672 | Benjamin Halpern | Dentist | 14344 Burnhaven Drive, Burnsville, MN 55306 | 2016-08-26 |
| 1356684419 | Shahir Nehad Abdel-malek | Dentist | 3555 Louisiana Ave S, Saint Louis Park, MN 55426-4121 | 2013-03-27 |
| 1386901858 | Jeanne L Barss | Dentist | 2550 University Ave W Ste 189s, Saint Paul, MN 55114-2001 | 2012-04-20 |
| 1205129012 | Jerod Thomas Klava | Dentist | 6545 France Ave. So., Suite 190, Edina, MN 55435 | 2011-05-26 |
| 1861784050 | Elham Akhlaghi | Dentist | 515 Delaware Street, Minneapolis, MN 55455 | 2011-05-06 |
| 1013216811 | Minneapolis-st. Paul Periodontics | Dentist | 1109 East Moore Lake Drive, Fridley, MN 55432 | 2011-03-18 |
| 1558516369 | Mdo Periodontics Pa | Dentist | 1900 Kruchten Ct S, Ste. 101, Sartell, MN 56377-4730 | 2008-11-20 |
| 1972770006 | Ying-lien Wu | Dentist | 150 S 5th St Ste 1475, Minneapolis, MN 55402-4212 | 2008-05-08 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on DR. PATRICK JOSEPH ENNEN.
| 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.