COMMUNITY DENTAL CARE


Address: 1670 Beam Ave, Maplewood, MN 55109-1201
Phone: 6519258400

COMMUNITY DENTAL CARE (NPI# 1992102040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1992102040
Entity Type Organization
Organization Name COMMUNITY DENTAL CARE
Practice Address 1670 Beam Ave
Maplewood
MN 55109-1201
Practice Telephone 6519258400
Mailing Telephone 6519258400
Enumeration Date 2014-12-04
Last Update Date 2014-12-04
Authorized Official Name DR. VACHAREE PETERSON (CEO)
Authorized Official Telephone 6519258400
Authorized Official Credential DDS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 305S00000X Point of Service H9154 MN Managed Care Organizations

Other Provider Identifier

State Issuer Identifier Type Code
MN 124Q00000X 05

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1548709330 Community Dental Care Dentist 2120 Highway 14 E, Rochester, MN 55904-5101 2017-02-14
1891100772 Community Dental Care Dentist 1926 Collegeview Rd E, Hc #116, Rochester, MN 55904-8201 2014-06-30

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities COMMUNITY DENTAL CARE 3910 Gaston Ave Ste 175, Dallas, TX 75246-1504
New York State Corporations COMMUNITY DENTAL CARE OF NYC, PLLC 47 East 167th Street, Bronx, Ny 10452

Office Location

Street Address 1670 BEAM AVE
City MAPLEWOOD
State MN
Zip Code 55109-1201

Providers in the same location

NPI Name Taxonomy Address Enumeration
1235311614 Community Dental Care Inc Dentist 1670 Beam Ave, Maplewood, MN 55109 2007-11-28
1053807016 123 Brush Dental LLC Clinic/Center 1670 Beam Ave, Ste 202, Maplewood, MN 55109 2018-07-02
1619346046 Kathleen Marie Grimm Dental Hygienist 1670 Beam Ave, Maplewood, MN 55109-1201 2015-09-16
1740657949 Bao Tran Dentist 1670 Beam Ave, Maplewood, MN 55109-1201 2015-08-24
1720460645 Todd James Billington Dentist 1670 Beam Ave, #204, Maplewood, MN 55109-1201 2015-06-27
1689086217 Ross John Schafer Dentist 1670 Beam Ave, Suite 204, Maplewood, MN 55109-1201 2014-06-02
1831509827 Metropolitan State University Dentist 1670 Beam Ave, #203, Maplewood, MN 55109-1201 2014-04-30
1942634597 Mallory Gowey Dentist 1670 Beam Ave, Suite 204, Maplewood, MN 55109-1201 2013-08-30
1720426877 Tyler Gordon Beinlich Dentist 1670 Beam Ave, Suite #204, Maplewood, MN 55109-1201 2013-06-11
1518305838 Diane Marie Fish Dentist 1670 Beam Ave, Maplewood, MN 55109-1201 2013-06-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1366063828 Jodi May Begordis Registered Nurse 2586 7th Ave East, Suite 302, North St Paul, MN 55109 2020-05-06
1467917146 Alejandro Diez Freire Social Worker 2468 Germain St, Maplewood, MN 55109 2019-02-06
1679099667 Rochelle Marie Clarke Registered Nurse 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 2017-08-21
1497298210 Salams Care Residential, LLC Home Health 2240 Ide Ct, Maplewood, MN 55109 2016-11-28
1093199630 Garry Allen Psychologist 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 2015-07-14
1700264751 Matthew Seng Thao Student in an Organized Health Care Education/Training Program 1470 Gervais Ave, Maplewood, MN 55109 2015-05-11
1326458340 Chong Chang Counselor 1705 Cope Ave E Ste I, Maplewood, MN 55109 2014-04-29
1619396488 Leah Anne Downey Occupational Therapist 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 2014-04-09
1356765440 Group Health Plan, Inc Clinic/Center 2520 12th Ave E, North St Paul, MN 55109 2014-02-10
1336560275 Veneman Dental Care, Pa Dentist 1774 Cope Ave, Suite 110, Maplewood, MN 55109 2013-12-19
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Taxonomy Information

Taxonomy Code 305S00000X
Grouping Managed Care Organizations
Classification Point of Service

Taxonomy Definition

This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1922635028 Wolf Therapeutic Massage Therapy Point of Service 914 4th Ave, Windom, MN 56101-1639 2020-03-26
1265975080 Cap Inc Point of Service 7376 200th Ave, Royalton, MN 56373-3614 2016-11-28
1639611890 Bdote Learning Center Point of Service 3216 E 29th St, Minneapolis, MN 55406-1780 2016-11-04
1679936025 Lingua Line LLC Point of Service 1409 11th Ave S Apt 408, Minneapolis, MN 55404-1417 2016-04-03
1184082471 Asian Chiropractic Inc. Point of Service 7827 Brooklyn Blvd, Brooklyn Park, MN 55445-2716 2016-02-02
1841613064 Global Lynx, LLC Point of Service 1415 Arcade St, Suite 202, Saint Paul, MN 55106-1822 2014-01-23
1487076238 Chatters Lumber Inc Point of Service 4715 17th Ave S, Minneapolis, MN 55407-3613 2014-01-14
1497193536 Annur Clinic LLC Point of Service 1729 Lyndale Ave N, Minneapolis, MN 55411-3349 2013-06-11
1982945184 Premeir Home Healthcare Point of Service 612 E 27th St, Minneapolis, MN 55407-1002 2013-03-13
1164700076 Sound Solutions Hearing Centers of Minnesota LLC. Point of Service 4101 W Division St Ste 4, Saint Cloud, MN 56301-3729 2011-07-26
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Competitor

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City MAPLEWOOD
Zip Code 55109

Improve Information

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Dataset Information

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.

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