PERIODONTAL SPECIALISTS, PA (NPI# 1740359546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740359546 |
| Entity Type | Organization |
| Organization Name | PERIODONTAL SPECIALISTS, PA |
| Practice Address |
2112 Viking Dr Nw Rochester MN 55901-3522 |
| Practice Telephone | 5072881338 |
| Mailing Telephone | 5072881338 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | TANYIA BUCHER (PRACTICE ADMINISTRATOR) |
| Authorized Official Telephone | 5074518151 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
07829 | MN | Dental Providers |
| Street Address |
2112 VIKING DR NW |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55901-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407844780 | Thomas Lyman Sitzer | Dentist | 2112 Viking Dr Nw, Valhalla Dental Building, Rochester, MN 55901-3522 | 2005-10-11 |
| 1396278503 | Seong Woo Lee | Dentist | 2112 Viking Dr Nw, Rochester, MN 55901-3522 | 2017-04-05 |
| 1235513755 | Zumbro Family Dental | Dentist | 2112 Viking Dr Nw, Suite G, Rochester, MN 55901-3522 | 2015-07-14 |
| 1730586579 | Advanced Periodontics & Implants Pllc | Dentist | 2112 Viking Dr Nw, Rochester, MN 55901-3522 | 2014-11-21 |
| 1720369812 | Thomas L. Sitzer, D.d.s., P.a. | Dentist | 2112 Viking Dr Nw, Valhalla Dental Building, Rochester, MN 55901-3522 | 2011-09-01 |
| 1629300298 | Marko Kamel Dds Pa | Health Maintenance Organization | 2112 Viking Dr Nw, Suite E, Rochester, MN 55901-3522 | 2010-02-08 |
| 1861693491 | Bryan Mark Recker | Dentist | 2112 Viking Dr Nw, Rochester, MN 55901-3522 | 2007-05-30 |
| 1285786822 | Vincent Monroe Hollaren | Dentist | 2112 Viking Dr Nw, Rochester, MN 55901-3522 | 2007-01-16 |
| 1225196363 | David J. Hagstrom LLC | Dentist | 2112 Viking Dr Nw, Rochester, MN 55901-3522 | 2006-12-04 |
| 1801968839 | Anthony Charles Michelich | Dentist | 2112 Viking Dr Nw, Rochester, MN 55901-3522 | 2006-11-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554627 | Austin Montgomery Gray | Chiropractor | 4229 West Frontage Rd Nw, Suite 4, Rochester, MN 55901 | 2020-10-01 |
| 1497303150 | Tatenda Valentine Rudziva | Nurse Practitioner | 2989 315 Elton Hills Drive Nw, Suite 201, Rochester, MN 55901 | 2019-08-27 |
| 1629566872 | Juan Simon Rico Mesa | Student in an Organized Health Care Education/Training Program | 4502 Medical Drive, San Antonio, 78229, San Antonio, TX 55901 | 2018-04-24 |
| 1336658277 | Minnesota Teen Challenge | Exclusive Provider Organization | 1542 Assisi Drive Nw, Rochester, MN 55901 | 2017-09-22 |
| 1235648270 | Mariah Adanene | Registered Nurse | 915 41st Street Nw, Rochester, MN 55901 | 2017-09-21 |
| 1912420639 | Anna Maria Schuman | Speech-Language Pathologist | 2746 Superior Drive Nw, Suite Number 150, Rochester, MN 55901 | 2017-07-25 |
| 1871013870 | Rhonda Keith | Counselor | 602 11th Avenue Nw #300, Rochester, MN 55901 | 2017-06-21 |
| 1548794316 | Trevor Kindle | Ophthalmology | 200 1st Ave Nw, Rochester, MN 55901 | 2017-04-18 |
| 1659810844 | Rx Team Home Health Care LLC | Home Health | 1027 7th St Nw Unit #204, Rochester, MN 55901 | 2017-02-21 |
| 1457713109 | Joshua Carter | Chiropractor | 3270 19th St Nw Ste 203, Rochester, MN 55901 | 2016-03-22 |
| Find all providers in zip 55901 | ||||
| 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 |
|---|---|---|---|---|
| 1053710673 | Ke Shang | Dentist | 2109 S Clinton Ave Ste 200, Rochester, NY 14618-2615 | 2014-08-19 |
| 1073929261 | Filip Ambrosio | Dentist | 2300 Buffalo Rd Bldg 400a, Rochester, NY 14624-1366 | 2014-07-08 |
| 1053510776 | Cristina Gabriela Ciornei | Dentist | 225 Parkwood Ave, Rochester, NY 14620-3405 | 2007-07-12 |
| 1871636365 | Edward David Appelbaum | Dentist | 45 Allens Creek Rd, Rochester, NY 14618-3227 | 2007-02-14 |
| 1538240254 | Paul David Hoffman | Dentist | 900 Westfall Rd Ste B, Rochester, NY 14618-2635 | 2006-10-18 |
| 1801984901 | Modern Periodontics, PC | Dentist | 1680 Monroe Ave, Suite A, Rochester, NY 14618-1417 | 2006-10-11 |
| 1487754305 | Caton, Blieden & Romano Dds, PC | Dentist | 2081 W. Ridge Rd, Rochester, NY 14626 | 2006-09-22 |
| 1265541858 | Jack Caton | Dentist | 2081 Ridge Rd W, Rochester, NY 14626-2724 | 2006-08-29 |
| 1174189088 | Elli Anna Kotsailidi | Dentist | 625 Elmwood Ave, Rochester, NY 14620-2913 | 2019-05-15 |
| 1396278503 | Seong Woo Lee | Dentist | 2112 Viking Dr Nw, Rochester, MN 55901-3522 | 2017-04-05 |
| Find all providers in ROCHESTER | ||||
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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.