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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 305S00000X | Point of Service | H9154 | MN | Managed Care Organizations |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | 124Q00000X | 05 |
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 |
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 |
Street Address |
1670 BEAM AVE |
City | MAPLEWOOD |
State | MN |
Zip Code | 55109-1201 |
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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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 |
Find all providers in zip 55109 |
Taxonomy Code | 305S00000X |
Grouping | Managed Care Organizations |
Classification | Point of Service |
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 |
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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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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.