DR. RICHARD BRIAN WITTENBERG (NPI# 1760596308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760596308 |
| Entity Type | Individual |
| Full Name | DR. RICHARD BRIAN WITTENBERG |
| Credential | D.D.S. |
| Practice Address |
13055 Riverdale Dr Nw Suite 400 Coon Rapids MN 55448-8403 |
| Mailing Address |
3880 Zircon Ln N Plymouth MN 55446-2837 |
| Practice Telephone | 6122439357 |
| Practice Fax Number | 7633237487 |
| Mailing Telephone | 7634788554 |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
8787 | MN | Dental Providers |
| Street Address |
13055 RIVERDALE DR NW SUITE 400 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55448-8403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699268474 | George Joseph Slovinski Sr. | Durable Medical Equipment & Medical Supplies | 13055 Riverdale Dr Nw, Coon Rapids, MN 55448-8403 | 2018-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447741152 | Modern Sisters Home Healthcare | Home Health | 1852 131st Ln Nw, Coon Rapids, MN 55448 | 2018-05-29 |
| 1003345463 | Sarah Benepe | Occupational Therapy Assistant | 764 107th Ln Nw, Coon Rapids, MN 55448 | 2017-06-08 |
| 1700310299 | Orthodontics Specialist of Minnesota P.l.l.c. | Dentist | 3360 Northdale Blvd Nw, Coon Rapids, MN 55448 | 2017-04-12 |
| 1528459906 | Shane R Fisher | Registered Nurse | 10077 Dogwood St. Nw, Suite 110, Minneapolis, MN 55448 | 2015-02-06 |
| 1912395419 | Mn Dentistry, PC | Dentist | 3570 River Rapids Drive Nw, Ste 110, Coor Rapids, MN 55448 | 2015-01-06 |
| 1215297536 | Daniel Beau Ryan Ellis | Chiropractor | 9 125 Lane Nw, Coon Rapids, MN 55448 | 2012-05-21 |
| 1306142344 | At Home Health Care Inc. | Home Health | 1601 128th Lane Nw, Coon Rapids, MN 55448 | 2011-02-09 |
| 1245428317 | Cassandra Joice Carney | Massage Therapist | 8770 Springbrook Dr Nw, Coon Rapids, MN 55448 | 2007-10-14 |
| 1982826434 | Merry Heart Home Care Inc | Home Health | 3248 131st Avenue Nw, Coon Rapids, MN 55448 | 2007-05-03 |
| 1659416196 | James T Sturm | Emergency Medicine | 10160 Foley Blvd Nw Ste 120, Coon Rapids, MN 55448 | 2007-02-21 |
| Find all providers in zip 55448 | ||||
| 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 |
|---|---|---|---|---|
| 1710944988 | Patrick Joseph Ennen | Dentist | 3960 Coon Rapids Blvd Nw, Suite 213, Coon Rapids, MN 55433-2569 | 2006-04-29 |
| 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 | 55448 |
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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.