MODERN DENTAL PROFESSIONALS MN PC (NPI# 1972786655) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972786655 |
| Entity Type | Organization |
| Organization Name | MODERN DENTAL PROFESSIONALS MN PC |
| Other Organization Name | MIDWEST DENTAL |
| Practice Address |
2215 2nd St Sw Suite 150 Rochester MN 55902-4147 |
| Practice Telephone | 5072815987 |
| Mailing Telephone | 5072815987 |
| Enumeration Date | 2007-12-17 |
| Last Update Date | 2007-12-17 |
| Authorized Official Name | JEFFREY MOOS (CEO) |
| Authorized Official Telephone | 7159265050 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D11386 | MN | Dental Providers |
| Other Name | Type Code |
|---|---|
| Midwest Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245413921 | Modern Dental Professionals Mn PC | Dentist | 226 Main St S, Chatfield, MN 55923-1225 | 2007-12-17 |
| 1235509084 | Modern Dental Professionals Mn PC | Dentist | 15594 Pilot Knob Rd, Suite 100, Apple Valley, MN 55124-7295 | 2015-10-05 |
| 1215307061 | Modern Dental Professionals Mn PC | Dentist | 195 Jefferson Blvd, Big Lake, MN 55309-9572 | 2015-10-05 |
| 1679866735 | Modern Dental Professionals Mn PC | Dentist | 24 S Olive St, Waconia, MN 55387-1404 | 2011-05-24 |
| 1861718173 | Modern Dental Professionals Mn PC | Dentist | 200 Village Center Dr, Suite 400, North Oaks, MN 55127-7090 | 2010-04-12 |
| 1487805925 | Modern Dental Professionals Mn PC | Dentist | 302 Fire Monument Rd, Hinckley, MN 55037-8350 | 2008-10-02 |
| 1881877553 | Modern Dental Professionals Mn PC | Dentist | 2355 Ariel St N, Suite A, Maplewood, MN 55109-2275 | 2007-12-17 |
| 1518140284 | Modern Dental Professionals Mn PC | Dentist | 1600 Gilmore Ave, Winona, MN 55987-2172 | 2007-12-17 |
| Street Address |
2215 2ND ST SW SUITE 150 |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55902-4147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205047800 | Robert Joel Gustafson | Chiropractor | 2215 2nd St Sw, Suite 140, Rochester, MN 55902-4147 | 2007-05-24 |
| 1538606264 | Bridget Skyhawk | Social Worker | 2215 2nd St Sw, Suite 200, Rochester, MN 55902-4147 | 2017-01-19 |
| 1871036483 | Renaux Rylee Swancutt | Social Worker | 2215 2nd St Sw, Suite 200, Rochester, MN 55902-4147 | 2016-11-30 |
| 1457768921 | Divya Bhalla | Dentist | 2215 2nd St Sw, Suite 150, Rochester, MN 55902-4147 | 2014-07-16 |
| 1366729790 | Southwest Chiropractic and Rehabilitation Services, Pa | Chiropractor | 2215 2nd St Sw, Suite 140, Rochester, MN 55902-4147 | 2011-11-14 |
| 1184923948 | Araye Health Services, LLC | Clinic/Center | 2215 2nd St Sw, Suite 190, Rochester, MN 55902-4147 | 2011-03-19 |
| 1326354044 | Remjoy Home Healthcare | Home Health | 2215 2nd St Sw, Suite 135, Rochester, MN 55902-4147 | 2010-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487264446 | Amber Nichelle Irby | Dental Therapist | 903 W Center St #130, Rochester, MN 55902 | 2020-08-05 |
| 1720584337 | John E Herman Home and Treatment Facility, LLC | Psychiatric Residential Treatment Facility | 351 14th Ave Sw, Rochester, MN 55902 | 2018-04-03 |
| 1912442898 | Esperanza Torres | Dental Hygienist | 903 West Center Street, Suite 130, United Way Bldg, Rochester, MN 55902 | 2016-12-30 |
| 1578971149 | Alduz Inri Surio Cabasa | Student in an Organized Health Care Education/Training Program | 609 1st Street Sw, Unit 102, Rochester, MN 55902 | 2014-07-28 |
| 1679901854 | Julie Erickson | Dental Hygienist | United Way Building Suite #208, Rochester, MN 55902 | 2013-10-24 |
| 1619313590 | Mercedes K Schulz | Dental Hygienist | 13394th Ave Sw, Rochester, MN 55902 | 2013-05-17 |
| 1093087389 | Sarah Jean Dennison | Clinic/Center | 930 West Center Street, Suite 208 United Way Bldg, Rochester, MN 55902 | 2012-02-01 |
| 1467732156 | Angela Elizabeth Peters | Registered Nurse | 1450 2nd Avenue Sw, Rochester, MN 55902 | 2011-08-25 |
| 1528350071 | Emily Zahasky Kraft | Pharmacist | 204 1st Street Sw, Rochester, MN 55902 | 2011-05-03 |
| 1093021982 | Sherry Dawn Boutcher | Dental Hygienist | 903 West Center Street Suite 208, United Way Building, Rochester, MN 55902 | 2010-08-30 |
| Find all providers in zip 55902 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164036422 | Lolita Hicks | Dentist | 1290 Salem Rd Sw Ste 10, Rochester, MN 55902-4210 | 2020-09-03 |
| 1356965248 | Tarin Allison Nassaney | Dentist | 40 Winter St Ste 201, Rochester, NH 03867-3139 | 2020-06-05 |
| 1629616206 | Stacey Starkes | Dentist | 1238 E Ridge Rd Ste 200, Rochester, NY 14621-2012 | 2019-12-14 |
| 1811459878 | Lakshmi Devi Ranjan Mandava | Dentist | 1000 Hylan Dr Ste B, Rochester, NY 14623-4218 | 2019-04-01 |
| 1417419409 | Scott J Koopman | Dentist | 3220 Chili Ave Ste 3, Rochester, NY 14624-5482 | 2019-04-01 |
| 1790246882 | Adriana Palacio | Dentist | 2052 S Clinton Ave, Rochester, NY 14618-5703 | 2019-03-29 |
| 1093213498 | David Lawrence | Dentist | 1000 E Henrietta Rd, Rochester, NY 14623-5701 | 2018-01-31 |
| 1518472604 | Scott Kanas | Dentist | 1002 E Gunn Rd, Rochester, MI 48306-1910 | 2017-12-11 |
| 1427587195 | Ryan Dental, LLC | Dentist | 216 Broadway Ave N, Rochester, MN 55906-3646 | 2017-06-07 |
| 1578008884 | Shilpa Singh | Dentist | 59 Lac Kine Dr, Rochester, NY 14618-5607 | 2016-12-21 |
| Find all providers in ROCHESTER | ||||
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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.