CENTRAL MINNESOTA PEDIATRIC DENTISTS PA (NPI# 1891136321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891136321 |
| Entity Type | Organization |
| Organization Name | CENTRAL MINNESOTA PEDIATRIC DENTISTS PA |
| Practice Address |
1100 19th Ave Sw Willmar MN 56201-5288 |
| Mailing Address |
1900 Centracare Cir Ste 350 Saint Cloud MN 56303-5000 |
| Practice Telephone | 3202530272 |
| Practice Fax Number | 3202512661 |
| Mailing Telephone | 3202530272 |
| Mailing Fax Number | 3202512661 |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2013-07-12 |
| Authorized Official Name | DR. MICHAEL W STEIL (PARTNER/OWNER) |
| Authorized Official Telephone | 3202530272 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D7765 | MN | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D11344 | MN | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
D11073 | MN | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396186813 | Central Minnesota Pediatric Dentists Pa | Dentist | 507 N Nokomis St Ste C, Alexandria, MN 56308-2353 | 2013-07-12 |
| 1265873707 | Central Minnesota Pediatric Dentists Pa | Dentist | 570 Humboldt Dr Ste 102, Big Lake, MN 55309-4844 | 2013-07-12 |
| Street Address |
1100 19TH AVE SW |
| City | WILLMAR |
| State | MN |
| Zip Code | 56201-5288 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548484652 | Jeremy Johnson | Dentist | 1100 19th Ave Sw, Suite 1, Willmar, MN 56201-5288 | 2007-04-12 |
| 1710535745 | Compass Chiropractic LLC | Chiropractor | 1100 19th Ave Sw, Suite 3, Willmar, MN 56201 | 2019-09-03 |
| 1811540487 | Tanner John Swystun | Chiropractor | 1100 19th Ave Sw, Suite 3, Willmar, MN 56201 | 2019-07-22 |
| 1114570934 | Kathleen Elizabeth Lippert Swystun | Chiropractor | 1100 19th Ave Sw, Suite 3, Willmar, MN 56201 | 2019-07-21 |
| 1144583527 | Great River Endodontics, Pa | Dentist | 1100 19th Ave Sw, Willmar, MN 56201-5006 | 2012-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730793472 | Sarah Erickson | Counselor | 2120 60th Ave N.w., Willmar, MN 56201 | 2020-09-01 |
| 1417560681 | Amy Engle | Nurse Practitioner | 1125 Se 8th Street, Willmar, MN 56201 | 2020-08-28 |
| 1154856524 | Mude Transportation Inc | Non-emergency Medical Transport (VAN) | 1712 Monongalia Ave Sw Ap1, Willmar, MN 56201 | 2017-04-24 |
| 1285025874 | Jill Fellows | Occupational Therapist | 611 5th St. Sw, Willmar, MN 56201 | 2015-02-18 |
| 1700294881 | Brenda Wiese | Counselor | 1617 Hwy 12 E, Suite 230, Willmar, MN 56201 | 2014-08-01 |
| 1275955932 | Courtney Regnier | Marriage & Family Therapist | 2320 E Hwy 12 Ste 2, Willmar, MN 56201 | 2014-01-15 |
| 1568732402 | Pamela Jean Kubesh | Social Worker | 328 Sw 3rd Street, Willmar, MN 56201 | 2012-01-10 |
| 1699931824 | Community Behavioral Health Hospital-willmar | Psychiatric Hospital | 1208 Olena Ave Se, Willmar, MN 56201 | 2008-08-07 |
| 1700053345 | Nathan Schrick | Marriage & Family Therapist | 513 Sw 5th Street, Box 1810, Willmar, MN 56201 | 2008-05-13 |
| 1831381680 | Joan M Blonigan Christianson | Chiropractor | 1101 S 1st Street, Willmar, MN 56201 | 2007-08-15 |
| Find all providers in zip 56201 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477025906 | Riverdale Kidds Pediatric Dentistry, Pllc | Dentist | 3585 124th Ave Nw Ste 400, Coon Rapids, MN 55433-1008 | 2018-12-21 |
| 1467924290 | Camp Smile Pediatric Dentistry Excelsior Pllc | Dentist | 675 Water St Ste 2, Excelsior, MN 55331-3072 | 2018-12-18 |
| 1932671765 | Camp Smile Pediatric Dentistry Chaska | Dentist | 111 Hundertmark Rd Ste 304n, Chaska, MN 55318-1587 | 2018-12-18 |
| 1538678057 | Blaine Kidds Pediatric Dentistry Pllc | Dentist | 1351 113th Ave Ne, Blaine, MN 55434-3874 | 2017-09-27 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1710367925 | Lindsay Bedeaux | Dentist | 7373 France Ave S Ste 400, Edina, MN 55435-4549 | 2015-06-02 |
| 1609272822 | Rochester Pediatric Dentistry LLC | Dentist | 1705 S Boradway Ave Ste B, Rochester, MN 55904-7960 | 2014-11-16 |
| 1396186813 | Central Minnesota Pediatric Dentists Pa | Dentist | 507 N Nokomis St Ste C, Alexandria, MN 56308-2353 | 2013-07-12 |
| 1265873707 | Central Minnesota Pediatric Dentists Pa | Dentist | 570 Humboldt Dr Ste 102, Big Lake, MN 55309-4844 | 2013-07-12 |
| 1013264621 | Northland Dental Partners | Dentist | 3507 Round Lake Blvd. Suite 900, Anoka, MN 55303 | 2012-08-14 |
| 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.