LAKE SUPERIOR DENTAL ASSOCIATES (NPI# 1871672584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871672584 |
| Entity Type | Organization |
| Organization Name | LAKE SUPERIOR DENTAL ASSOCIATES |
| Practice Address |
1225 E 1st St Duluth MN 55805-2402 |
| Practice Telephone | 2187286445 |
| Practice Fax Number | 2187247003 |
| Mailing Telephone | 2187286445 |
| Mailing Fax Number | 2187247003 |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-10-30 |
| Authorized Official Name | DR. ROBERT G RYAN (PARTNER) |
| Authorized Official Telephone | 2187286445 |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS MN | 7B014FO | 01 |
| MN | UNITED CONCORDIA | 820436 | 01 |
| Street Address |
1225 E 1ST ST |
| City | DULUTH |
| State | MN |
| Zip Code | 55805-2402 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639183726 | Melanie Sue Meier Buhr | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2006-07-27 |
| 1649687674 | Jeffrey Polzin | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2014-07-22 |
| 1669894705 | Sla Dental Pllc | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2014-01-08 |
| 1922343268 | Erin Kathryn Fossum Renier | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2012-11-27 |
| 1427369677 | Seth Amadio | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2010-06-23 |
| 1891011748 | Ross Allen Anderson | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2010-04-18 |
| 1780744136 | Steven Boyd Kottke | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2006-12-08 |
| 1255410973 | Rodney A Heller | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2006-11-03 |
| 1952488132 | Robert G Ryan | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2006-11-01 |
| 1699868745 | Scott Alan Polzin | Dentist | 1225 E 1st St, Duluth, MN 55805-2402 | 2006-10-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356852180 | Peace of Mind of Duluth, Inc. | Community/Behavioral Health | 1000 East 1st Street, Suite 100, Duluth, MN 55805 | 2017-10-19 |
| 1891213419 | Arielle Skalisky | Registered Nurse | 400 E. 3rd Street, Duluth, MN 55805 | 2017-09-04 |
| 1457886400 | Chefrdn, LLC | Dietitian, Registered | 1101 East 4th Street, Duluth, MN 55805 | 2017-04-27 |
| 1962811604 | Claire Elena Kap | Nurse Practitioner | Essentia Health Duluth Clnic, 400 East Third Street, Duluth, MN 55805 | 2014-08-06 |
| 1598196313 | Kelsey Lindsay Putvin | Audiologist | 400 E 3rd St., Duluth, MN 55805 | 2013-12-04 |
| 1639462997 | James F Conniff | Family Medicine | Duluth Family Medicine Clinic, 330 N Eighth Ave E, Duluth, MN 55805 | 2011-05-19 |
| 1215237433 | Bobby Jo Mineheine | Speech-Language Pathologist | 530 East Second St, Polinsky Medical Rehab Ctr, Duluth, MN 55805 | 2010-10-22 |
| 1891004248 | Robin Michelle Warfel | Occupational Therapist | 530 East 2nd Street, Polinsky Medical Rehabilitation Center, Duluth, MN 55805 | 2010-10-04 |
| 1154638716 | Jennifer Chen | Pharmacist | 420 E 1st St Mail Drop 1s3w10, Duluth, MN 55805 | 2010-09-02 |
| 1376858084 | Jennifer Lynn Howard | Pharmacist | 211 West Fourth Street, Center for American Indian Resources, Duluth, MN 55805 | 2010-08-18 |
| Find all providers in zip 55805 | ||||
| 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 |
|---|---|---|---|---|
| 1023677275 | Gabrielle Lina Going | Dentist | 2405 Satellite Blvd Ste 115, Duluth, GA 30096-9022 | 2019-06-11 |
| 1093296733 | Marharyta Viarkhouskaya | Dentist | 2550 Pleasant Hill Rd Ste 119, Duluth, GA 30096-9278 | 2018-08-21 |
| 1881114015 | Eric Michael Anderson | Dentist | 2925 Premiere Pkwy Ste 165, Duluth, GA 30097-5258 | 2017-06-20 |
| 1790213825 | Devan Callaway | Dentist | 3415 Highway 120, Duluth, GA 30096-3354 | 2017-06-02 |
| 1184161119 | George Marius Dinulescu | Dentist | 3780 Old Norcross Rd Ste 303, Duluth, GA 30096-1742 | 2017-01-29 |
| 1801260187 | Bluestone Dental Pllc | Dentist | 906 Woodland Avenue, Duluth, MN 55812-1113 | 2015-11-24 |
| 1144600859 | Camille Zelen Dds Pa | Dentist | 1624 Woodland Ave, Duluth, MN 55803-2628 | 2015-06-08 |
| 1205230976 | Ace Dental Care, LLC | Dentist | 7990 Turnberry Way, Duluth, GA 30097-1634 | 2014-10-09 |
| 1588904619 | Janet Stuckwish Dunwody | Dentist | 3677 Habersham Ln, Duluth, GA 30096-6111 | 2013-02-27 |
| 1124305057 | Jong S Lee | Dentist | 4855 River Green Pkwy Ste 110, Duluth, GA 30096-8333 | 2011-11-06 |
| Find all providers in DULUTH | ||||
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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.