DR. MICHAEL BRYAN MISKOVICH (NPI# 1841426756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841426756 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL BRYAN MISKOVICH |
| Credential | DDS |
| Practice Address |
612 13th St S Virginia MN 55792-3149 |
| Mailing Address |
612-13th. St. So. Virginia MN 55792 |
| Practice Telephone | 2187410405 |
| Practice Fax Number | 2187411445 |
| Mailing Telephone | 2187410405 |
| Mailing Fax Number | 2187411445 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D12649 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | DENTAL LICENSE | D12649 | 01 |
| Street Address |
612 13TH ST S |
| City | VIRGINIA |
| State | MN |
| Zip Code | 55792-3149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578579017 | Mark Arnold Erickson | Dentist | 612 13th St S, Virginia, MN 55792-3149 | 2006-08-01 |
| 1114031549 | Kenneth Carl Holbeck | Dentist | 612 13th St S, Virginia, MN 55792-3149 | 2006-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598252983 | Teresa A Larrabee | Social Worker | 624 South 13th Street, Virginia, MN 55792 | 2018-04-20 |
| 1972874105 | Caryn M. Walters | Counselor | 504 1st St. S., Virginia, MN 55792 | 2012-01-19 |
| 1144502923 | Crystal Corrine Leal | Student in an Organized Health Care Education/Training Program | 624 S. 13th St., Virginia, MN 55792 | 2011-09-16 |
| 1417259110 | Ellen C. Taube | Pharmacist | 306 Chestnut, Virginia, MN 55792 | 2010-12-01 |
| 1518295567 | Virginia-gilbert Family Dental P.a | Dentist | 612-13th. St. So., Virginia, MN 55792 | 2009-12-03 |
| 1942442082 | Arrowhead Economic Opportunity Agency | In Home Supportive Care | 702 South Third Avenue, Virginia, MN 55792 | 2009-04-06 |
| 1609037324 | Stefan Leroy Kaiser | Preventive Medicine | 1101 9th St. N, Essentia Health Virginia Clinic, Virginia, MN 55792 | 2008-06-25 |
| 1457512915 | Duane Faccin Person | Legal Medicine | 910 6th St N, Duluth Clinic Virginia, Virginia, MN 55792 | 2008-06-18 |
| 1932368313 | Range Mental Health Center Inc | Community Based Residential Treatment Facility, Mental Illness | 731 3rd St S, Virginia, MN 55792 | 2008-06-02 |
| 1871634071 | Gary Frederick Miller | Social Worker | 624 S 13th Street, P O 1188, Virginia, MN 55792 | 2007-02-09 |
| Find all providers in zip 55792 | ||||
| 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 |
|---|---|---|---|---|
| 1215271051 | James Eliasen | Dentist | 1205 20th St S, Virginia, MN 55792-3724 | 2012-11-17 |
| 1518295567 | Virginia-gilbert Family Dental P.a | Dentist | 612-13th. St. So., Virginia, MN 55792 | 2009-12-03 |
| 1750501136 | Bassing & Bassing, Ltd. | Dentist | 235 1/2 Chestnut St, Virginia, MN 55792-2510 | 2007-04-26 |
| 1790735512 | David D Witschen | Dentist | 710 9th St N, Virginia, MN 55792-2322 | 2006-05-11 |
| 1194033217 | Denise Chiu | Dentist | 331 S Main St, Virginia, IL 62691-1519 | 2010-09-23 |
| 1174751531 | Dental Associates, Ltd. | Dentist | 108 N 3rd Ave, Virginia, MN 55792-2519 | 2009-06-24 |
| 1083880991 | Joann Marold Bassing | Dentist | 235 1/2 Chestnut St, Virginia, MN 55792-2510 | 2008-05-01 |
| 1952577868 | John Joseph Bassing | Dentist | 235 1/2 Chestnut St, Virginia, MN 55792-2510 | 2008-05-01 |
| 1134325160 | William P Capati | Dentist | 331 S Main St, Virginia, IL 62691-1519 | 2007-06-26 |
| 1225192602 | Dennis Lee Carlson | Dentist | 302 Chestnut St, 200 Tini Square Bldg., Virginia, MN 55792-2541 | 2006-12-20 |
| Find all providers in VIRGINIA | ||||
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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.