DENTAL SPECIALISTS OF MINNESOTA, PLLC (NPI# 1902235245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902235245 |
| Entity Type | Organization |
| Organization Name | DENTAL SPECIALISTS OF MINNESOTA, PLLC |
| Other Organization Name | THE DENTAL SPECIALIST WOODBURY |
| Practice Address |
10150 City Walk Dr Apt C Woodbury MN 55129-9270 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2550 |
| Practice Telephone | 6515010018 |
| Mailing Telephone | 6516330500 |
| Mailing Fax Number | 6516366350 |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | SHANNON HESSE (CREDENTIALING SPECIALIST) |
| Authorized Official Telephone | 6517462815 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Other Name | Type Code |
|---|---|
| The Dental Specialist Woodbury | Doing Business As Name - Organization |
| The Dental Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396095048 | Dental Specialists of Minnesota, Pllc | Dentist | 3360 Northdale Blvd., Coon Rapids, MN 55448-1825 | 2012-09-10 |
| 1922308113 | Dental Specialists of Minnesota, Pllc | Dentist | 12904 Central Ave. Ne, Blaine, MN 55434 | 2010-10-22 |
| 1508932344 | Dental Specialists of Minnesota, Pllc | Dentist | 40 W Nicollet Blvd, Burnsville, MN 55337-4524 | 2006-11-24 |
| 1780750539 | Dental Specialists of Minnesota, Pllc | Dentist | 1835 County Road C-west, Suite 200, Roseville, MN 55113-1343 | 2006-11-24 |
| 1003431263 | Dental Specialists of Minnesota, Pllc | Dentist | 14525 Highway 7 Ste 125, Minnetonka, MN 55345-3738 | 2020-06-13 |
| 1760013015 | Dental Specialists of Minnesota, Pllc | Dentist | 15015 Cimarron Ave, Rosemount, MN 55068-2771 | 2020-01-27 |
| 1851772362 | Dental Specialists of Minnesota, Pllc | Dentist | 2200 County Road C W, Suite 2210, Roseville, MN 55113-2550 | 2015-06-11 |
| 1619382876 | Dental Specialists of Minnesota, Pllc | Dentist | 12180 Business Park Blvd N, Champlin, MN 55316-4525 | 2014-06-26 |
| 1558776716 | Dental Specialists of Minnesota, Pllc | Dentist | 1150 Hazeltine Blvd, Chaska, MN 55318-1004 | 2014-06-26 |
| 1710317417 | Dental Specialists of Minnesota, Pllc | Dentist | 11240 Stillwater Blvd N, Lake Elmo, MN 55042-9321 | 2013-11-15 |
| Street Address |
10150 CITY WALK DR APT C |
| City | WOODBURY |
| State | MN |
| Zip Code | 55129-9270 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407948060 | Kristy Lynn Petersen | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2006-09-29 |
| 1013517093 | Orthodontic Specialists of Minnesota, Pllc | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2020-10-28 |
| 1184716755 | Lori Marie Gmeinder | Dentist | 10150 City Walk Dr Apt C, Woodbury, MN 55129-9270 | 2006-09-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770006983 | Logan Thompson | Chiropractor | 10631 Pond Curve, Woodbury, MN 55129 | 2017-07-19 |
| 1942650619 | The Hendricks Group Inc. | Assisted Living Facility | 10025 Antrim Court, Woodbury, MN 55129 | 2016-06-14 |
| 1235588468 | Nathan Robert Mayernik | Physical Therapist | 4123 Radio Dr, Suite 100, Woodbury, MN 55129 | 2016-06-08 |
| 1699146035 | St. Therese of Woodbury, LLC | Skilled Nursing Facility | 7555 Bailey Road, Woodbury, MN 55129 | 2015-10-12 |
| 1548602865 | Monica Bajracharya | Internal Medicine | 9373 Compass Pointe Rd, Woodbury, MN 55129 | 2013-07-28 |
| 1730454752 | Amanda E Feeney | Physical Therapist | 4123 Radio Drive, Ste 100, Woodbury, MN 55129 | 2012-03-09 |
| 1104193762 | Minneapolis-st.paul Endodontics | Dentist | 10150 City Walk Dr Ste C, Woodbury, MN 55129 | 2011-11-28 |
| 1659502417 | Charles Goff Jr. | Marriage & Family Therapist | 1919 University Ave W Suite 200, St. Paul, MN 55129 | 2009-07-28 |
| 1497821391 | Kyle Riley Edlund | Dentist | 3060 Woodbury Drive, #b, Woodbury, MN 55129 | 2006-11-24 |
| 1902979206 | Robert Edgar Eng | Dentist | 3100 Woodbury Drive, Woodbury, MN 55129 | 2006-11-16 |
| Find all providers in zip 55129 | ||||
| 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 |
|---|---|---|---|---|
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1710976204 | Stuart A Wasserlauf | Dentist | 142 Emerson St, Suite B, Woodbury, NJ 08096-3235 | 2005-10-18 |
| 1568820710 | Lisa Ritter-kahn | Dentist | 800 Woodbury Rd, E, Woodbury, NY 11797-2503 | 2016-02-03 |
| 1922485937 | Douglas Schildhaus | Dentist | 800 Woodbury Rd, Woodbury, NY 11797-2503 | 2015-04-28 |
| 1366774945 | Drs. Ritter-kahn and Schildhaus, Dmd PC | Dentist | 800 Woodbury Rd, Suite E, Woodbury, NY 11797-2503 | 2010-02-05 |
| 1891876595 | Baylon Beinlich Dds LLC | Dentist | 9950 Valley Creek Rd, Suite 150, Woodbury, MN 55125-4883 | 2006-10-18 |
| 1255412961 | Greg Steven Beinlich | Dentist | 9950 Valley Creek Rd, Suite 150, Woodbury, MN 55125-4883 | 2006-10-18 |
| 1760563480 | Richard James Baylon | Dentist | 9950 Valley Creek Rd, Suite 150, Woodbury, MN 55125-4883 | 2006-10-18 |
| 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 |
| 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 |
| 1407131618 | St. Croix Kidds Pediatric Dentistry | Dentist | 4951 Morehead Ave, White Bear Lake, MN 55110-2633 | 2011-10-19 |
| 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.