PINE RIVER DENTAL ARTS, P.C. (NPI# 1962851071) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962851071 |
| Entity Type | Organization |
| Organization Name | PINE RIVER DENTAL ARTS, P.C. |
| Practice Address |
203 Park Ave Pine River MN 56474 |
| Mailing Address |
Po Box 650 Pine River MN 56474-0650 |
| Practice Telephone | 2185874437 |
| Practice Fax Number | 2185874479 |
| Mailing Telephone | 2185874437 |
| Mailing Fax Number | 2185874479 |
| Enumeration Date | 2016-06-09 |
| Last Update Date | 2016-06-09 |
| Authorized Official Name | JAIME LYN PREBLE (OWNER) |
| Authorized Official Telephone | 2185874437 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D13283 | MN | Dental Providers |
| Street Address |
203 PARK AVE |
| City | PINE RIVER |
| State | MN |
| Zip Code | 56474 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871932798 | Jaime Lyn Preble | Dentist | 203 Park Ave, Pine River, MN 56474 | 2013-06-25 |
| 1255426722 | Owen W. Johnson | Dentist | 203 Park Ave, Pine River, MN 56474 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033680046 | Brainerd Medical Center Inc | Pharmacy | 280 Barclay Ave W, Ste 1100, Pine River, MN 56474 | 2018-12-17 |
| 1518057751 | Cass & Crow Wings Cos Ind School Dist 2174 | Local Education Agency (LEA) | 401 Murray Avenue, Pine River, MN 56474 | 2006-10-16 |
| 1164512646 | John Charles Redebaugh | Chiropractor | 5314 Nisswa Ave, Nisswa, MN 56474 | 2006-10-13 |
| 1124205075 | Jamie Lynne Olson | Occupational Therapist | 518 Jefferson Ave, Pine River, MN 56474 | 2008-01-23 |
| 1558546036 | Annette M Pohl | Physical Therapist | 518 Jefferson Ave, Pine River, MN 56474-0029 | 2008-01-03 |
| 1124035191 | Pine River Eye Center, Inc. | Optometrist | 424 Barclay Ave., Pine River, MN 56474-0457 | 2006-08-02 |
| 1396710125 | Michael S Marvin | Optometrist | 424 Barclay Ave, Pine River, MN 56474-0457 | 2006-02-23 |
| 1023626918 | Tucker A Sheley | Nurse Practitioner | 415 Barclay Ave, Pine River, MN 56474-1603 | 2020-07-17 |
| 1679753263 | Melissa Deckard | Specialist | 530 2nd St Sw, Pine River, MN 56474-4019 | 2007-11-12 |
| 1629338686 | Northwoods Dna, Inc. | Assisted Living Facility | 2729 State 371 Sw, Pine River, MN 56474-4025 | 2012-05-24 |
| Find all providers in zip 56474 | ||||
| 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 |
|---|---|---|---|---|
| 1932515269 | Steven Carlson | Dentist | 203 Park Ave W, Pine River, MN 56474-4495 | 2014-07-08 |
| 1265845937 | Pine River Dental Center LLC | Dentist | 203 Park Ave W, Pine River, MN 56474-4495 | 2014-06-10 |
| 1255426722 | Owen W. Johnson | Dentist | 203 Park Ave, Pine River, MN 56474 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001149 | Kalyan Chakravarthy Kondreddi | Dentist | 327 Western Ave Ste A, Fergus Falls, MN 56537-2403 | 2020-10-20 |
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1770190951 | Bluff Creek Dental Pllc | Dentist | 600 Market St Ste 130, Chanhassen, MN 55317-4570 | 2020-09-30 |
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1073128153 | Michael W Flinn Dds, Pa | Dentist | 200 Firewood Drive, Redwood, MN 56283 | 2020-09-15 |
| 1770196891 | Thomas J Hoeffel Dds Pa | Dentist | 2819 Hamline Ave N Ste 104, Roseville, MN 55113-7718 | 2020-08-28 |
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 1679182687 | Downtown Dental Center Pllc | Dentist | 825 Nicollet Mall Ste 1427, Minneapolis, MN 55402-2703 | 2020-07-26 |
| 1205444791 | Patrick Reilly Steck | Dentist | 4948 S 34th Ave, Minneapolis, MN 55417 | 2020-07-21 |
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| Find all providers with the same taxonomy | ||||
| City | PINE RIVER |
| Zip Code | 56474 |
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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.