EAST CENTRAL DENTAL CLINIC, PA (NPI# 1871535344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871535344 |
| Entity Type | Organization |
| Organization Name | EAST CENTRAL DENTAL CLINIC, PA |
| Practice Address |
110 5th St Nw Braham MN 55006-3015 |
| Mailing Address |
Po Box 170 Braham MN 55006-0170 |
| Practice Telephone | 3203964417 |
| Practice Fax Number | 3203964417 |
| Mailing Telephone | 3203964417 |
| Mailing Fax Number | 3203964417 |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2014-11-30 |
| Authorized Official Name | DR. JAMES A. RADZIUN (PRESIDENT) |
| Authorized Official Telephone | 3203964417 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D9743 | MN | Ambulatory Health Care Facilities |
| Street Address |
110 5TH ST NW |
| City | BRAHAM |
| State | MN |
| Zip Code | 55006-3015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124519400 | Braham Family Dental | Clinic/Center | 110 5th St Nw, Braham, MN 55006 | 2018-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518192756 | David Michael Noren | Rehabilitation Practitioner | 521 Broadway Ave N, Braham, MN 55006 | 2009-05-18 |
| 1851513477 | James Allen Radziun | Dentist | 110 5th Street Nw, Braham, MN 55006 | 2007-05-03 |
| 1033259411 | Christine Tande Johnson | Psychologist | 521 Broadway Ave North, Five County Mental Health Center, Braham, MN 55006 | 2007-02-07 |
| 1235279621 | John Theophile Lindquist | Psychologist | 521 Broadway Avenue North, Five County Mental Health Center, Braham, MN 55006 | 2007-02-07 |
| 1679612782 | Jennifer Nell White | Psychologist | Five County Mental Health Center, 521 Broadway Avenue North, Braham, MN 55006 | 2007-02-05 |
| 1174777981 | Kimberly Jane Yzermans Nelson | Case Manager/Care Coordinator | 521 Broadway Avenue North, Firve County Mental Health Center - Braham Office, Braham, MN 55006 | 2008-11-06 |
| 1184877599 | Derek Thomas Magaard | Rehabilitation Practitioner | 521 Broadway Avenue North, Five County Mental Health Center - Braham Office, Braham, MN 55006 | 2008-10-29 |
| 1366694473 | Jody Lyn Dixon | Case Manager/Care Coordinator | 521 Broadway Avenue North, Five County Mental Health Center - Braham Office, Braham, MN 55006 | 2008-10-21 |
| 1629220736 | Roxanne Lynn Anderson | Case Manager/Care Coordinator | 521 Broadway Avenue North, Five County Mental Health Center - Braham Office, Braham, MN 55006 | 2008-10-21 |
| 1447402557 | Kimberly Marie Norberg | Case Manager/Care Coordinator | 521 Broadway Avenue North, Five County Mental Health Center - Braham Office, Braham, MN 55006 | 2008-10-21 |
| Find all providers in zip 55006 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124519400 | Braham Family Dental | Clinic/Center | 110 5th St Nw, Braham, MN 55006 | 2018-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710025 | Theresa M. Snell | Clinic/Center | 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 | 2020-11-05 |
| 1376143248 | James M. Williams, D.d.s., P.a. | Clinic/Center | 620 Union St S, Mora, MN 55051-1818 | 2020-10-29 |
| 1235746058 | Asp Dental, PC | Clinic/Center | 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 | 2020-09-25 |
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1518574532 | Stillwater Family Dental | Clinic/Center | 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 | 2020-09-24 |
| 1093321531 | Barnett Dental Inc | Clinic/Center | 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 | 2020-09-21 |
| 1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
| 1770195158 | Mark T. Sherman Dds Pa | Clinic/Center | 31011 Rasmussen Rd, Pequot Lakes, MN 56472-1227 | 2020-08-18 |
| 1689286015 | Lifelong Dental Care | Clinic/Center | 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 | 2020-08-18 |
| 1528678497 | Custom Smiles Dentistry, Pllc | Clinic/Center | 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
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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.