MODERN DENTAL PROFESSIONALS, MN PC (NPI# 1770939613) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770939613 |
| Entity Type | Organization |
| Organization Name | MODERN DENTAL PROFESSIONALS, MN PC |
| Other Organization Name | MIDWEST DENTAL FARMINGTON |
| Practice Address |
20700 Chippendale Ave W Suite 10 Farmington MN 55024-8207 |
| Practice Telephone | 6513158229 |
| Practice Fax Number | 6515710142 |
| Mailing Telephone | 6513158229 |
| Mailing Fax Number | 6515710142 |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |
| Authorized Official Name | ELIZABETH RYDELL (GENERAL DENTIST) |
| Authorized Official Telephone | 7159265050 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Midwest Dental Farmington | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710357520 | Modern Dental Professionals, Mn PC | Dentist | 1625 Lena Ct, Suite 100, Eagan, MN 55122-2959 | 2015-10-06 |
| 1003286808 | Modern Dental Professionals, Mn PC | Dentist | 2147 Northdale Blvd Nw, Nwood, Coon Rapids, MN 55433-3006 | 2015-10-06 |
| 1144513565 | Modern Dental Professionals, Mn PC | Dentist | 507 S Shore Dr, Worthington, MN 56187-1400 | 2011-05-18 |
| 1710358379 | Modern Dental Professionals, Mn PC | Dentist | 7532 Brooklyn Blvd, Brooklyn Park, MN 55443-3101 | 2015-10-08 |
| 1881060069 | Modern Dental Professionals, Mn PC | Dentist | 3909 Silver Lake Rd Ne, Minneapolis, MN 55421-4352 | 2015-08-11 |
| 1558643817 | Modern Dental Professionals, Mn PC | Dentist | 4140 Thielman Ln, Suite 302, Saint Cloud, MN 56301-7326 | 2011-09-13 |
| 1679853451 | Modern Dental Professionals, Mn PC | Dentist | 107 Dupont Ave Nw, Renville, MN 56284 | 2011-08-24 |
| 1295965572 | Modern Dental Professionals, Mn PC | Dentist | 379 S Main St, Zumbrota, MN 55992-1543 | 2009-07-21 |
| 1073796744 | Modern Dental Professionals, Mn PC | Dentist | 560 Debra Dr, Lewiston, MN 55952-2104 | 2007-12-17 |
| 1124159983 | Modern Dental Professionals, Mn PC | Dentist | 680 Hehli Way, Mondovi, WI 54755-1639 | 2007-03-07 |
| Street Address |
20700 CHIPPENDALE AVE W SUITE 10 |
| City | FARMINGTON |
| State | MN |
| Zip Code | 55024-8207 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982263190 | Taylor Kuhn | Physical Therapist | 20700 Chippendale Ave W, Farmington, MN 55024-8207 | 2019-06-11 |
| 1790226736 | Miriah Mantik | Acupuncturist | 20700 Chippendale Ave W, Suite 7, Farmington, MN 55024-8207 | 2017-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932758158 | Renetia Jackson | Technician | 1210 Spruce Street, Farmington, MN 55024 | 2019-09-10 |
| 1871094912 | Megan Provost | Registered Nurse | 17680 Formosa Ave, Farmington, MN 55024 | 2018-02-23 |
| 1356752463 | Your Vision Achieved, LLC | Marriage & Family Therapist | 5404 187th Street West, Farmington, MN 55024 | 2014-05-12 |
| 1427304203 | Joseph Samuel Emond Jr. | Family Medicine | 19730 Meadowlark Way, Farmington, MN 55024 | 2012-07-30 |
| 1053680991 | Annie Lee Mickelson | Chiropractor | 20700 Chippendale Ave Suite 7, Farmington, MN 55024 | 2011-12-21 |
| 1770770828 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 19605 Pilot Knob Rd., Farmington, MN 55024 | 2007-10-02 |
| 1275725277 | Family Vision Clinic of Farmington | Optometrist | 19650 Pilot Knob Road, Farmington, MN 55024 | 2007-08-14 |
| 1871503136 | Independent School District #192 | Early Intervention Provider Agency | 20655 Flagstaff Avenue, Farmington, MN 55024 | 2006-08-09 |
| 1588692669 | Northfield Hospital | Clinic/Center | 4645 Knutsen Dr, Farmington, MN 55024 | 2006-06-29 |
| 1902887284 | David E Truax | Chiropractor | 20700 Chippendale Ave, Suite 7, Farmington, MN 55024 | 2005-11-14 |
| Find all providers in zip 55024 | ||||
| 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 |
|---|---|---|---|---|
| 1407416977 | Alexander Michael Shore | Dentist | 33153 Maplenut St, Farmington, MI 48336-4438 | 2019-06-17 |
| 1629596705 | Dds Catalyst Farmington, LLC | Dentist | 3501 N Butler Ave Ste 104, Farmington, NM 87401-6430 | 2017-09-08 |
| 1750802997 | Ryan Michael Holbrook | Dentist | 640 W Karsch Blvd, Farmington, MO 63640-3342 | 2017-06-28 |
| 1508232992 | Christopher Nicholaus Roclevitch | Dentist | 3030 E Main St, T-1, Farmington, NM 87402-7636 | 2015-08-19 |
| 1003200569 | Pure Dental PC | Dentist | 2 Forest Park Dr Ste 1, Farmington, CT 06032-1446 | 2015-03-23 |
| 1417346016 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 520 W. Pine Street, Farmington, MO 63640-1426 | 2015-01-20 |
| 1487913869 | Modern Dental Professionals Utah, PC | Dentist | 280 N Union Ave, #l110, Farmington, UT 84025 | 2012-05-07 |
| 1427320654 | Summit Family Dental of Farmington, LLC | Dentist | 800 E 30th St Bldg 3, Farmington, NM 87401-9407 | 2012-02-03 |
| 1851679393 | Peter Urling | Dentist | 19 S. Franklin St., Farmington, MO 63640 | 2011-08-02 |
| 1437443280 | Yuriy May | Dentist | 10 Birdseye Rd Ste 240, Farmington, CT 06032-2489 | 2011-06-08 |
| Find all providers in FARMINGTON | ||||
| City | FARMINGTON |
| Zip Code | 55024 |
Please comment or provide details below to improve the information on MODERN DENTAL PROFESSIONALS, MN PC.
| 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.