MODERN DENTAL PROFESSIONALS, MN PC (NPI# 1003286808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003286808 |
| Entity Type | Organization |
| Organization Name | MODERN DENTAL PROFESSIONALS, MN PC |
| Other Organization Name | MIDWEST DENTAL |
| Practice Address |
2147 Northdale Blvd Nw Nwood Coon Rapids MN 55433-3006 |
| Practice Telephone | 7637674888 |
| Practice Fax Number | 7637674889 |
| Mailing Telephone | 7637674888 |
| Mailing Fax Number | 7637674889 |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |
| Authorized Official Name | JEFFREY W MOOS (OWNER) |
| Authorized Official Telephone | 7158292791 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| Midwest Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770939613 | Modern Dental Professionals, Mn PC | Dentist | 20700 Chippendale Ave W, Suite 10, Farmington, MN 55024-8207 | 2016-05-10 |
| 1710357520 | Modern Dental Professionals, Mn PC | Dentist | 1625 Lena Ct, Suite 100, Eagan, MN 55122-2959 | 2015-10-06 |
| 1144513565 | Modern Dental Professionals, Mn PC | Dentist | 507 S Shore Dr, Worthington, MN 56187-1400 | 2011-05-18 |
| 1710358379 | Modern Dental Professionals, Mn PC | Dentist | 7532 Brooklyn Blvd, Brooklyn Park, MN 55443-3101 | 2015-10-08 |
| 1881060069 | Modern Dental Professionals, Mn PC | Dentist | 3909 Silver Lake Rd Ne, Minneapolis, MN 55421-4352 | 2015-08-11 |
| 1558643817 | Modern Dental Professionals, Mn PC | Dentist | 4140 Thielman Ln, Suite 302, Saint Cloud, MN 56301-7326 | 2011-09-13 |
| 1679853451 | Modern Dental Professionals, Mn PC | Dentist | 107 Dupont Ave Nw, Renville, MN 56284 | 2011-08-24 |
| 1295965572 | Modern Dental Professionals, Mn PC | Dentist | 379 S Main St, Zumbrota, MN 55992-1543 | 2009-07-21 |
| 1073796744 | Modern Dental Professionals, Mn PC | Dentist | 560 Debra Dr, Lewiston, MN 55952-2104 | 2007-12-17 |
| 1124159983 | Modern Dental Professionals, Mn PC | Dentist | 680 Hehli Way, Mondovi, WI 54755-1639 | 2007-03-07 |
| Street Address |
2147 NORTHDALE BLVD NW NWOOD |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-3006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477112456 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 2147 Northdale Blvd Nw, Coon Rapids, MN 55433 | 2019-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| 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 |
|---|---|---|---|---|
| 1245857655 | Paul Yaeger | Dentist | 3570 River Rapids Dr Nw, Coon Rapids, MN 55448-4100 | 2020-07-01 |
| 1932767688 | Levi Bursch | Dentist | 3570 River Rapids Dr Nw # 110, Coon Rapids, MN 55448-4100 | 2019-05-29 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1316450091 | Tran Dental LLC | Dentist | 3570 River Rapids Dr Nw Ste 110, Coon Rapids, MN 55448-4100 | 2017-11-16 |
| 1609279140 | Marissa Kaplan | Dentist | 13040 Riverdale Dr Nw Ste 600, Coon Rapids, MN 55448-8419 | 2014-09-29 |
| 1467899708 | Sanket R Nagarkar | Dentist | 3161 Northdale Blvd, Coon Rapids, MN 55433 | 2013-05-28 |
| 1619287562 | Northdale Dentist Pa | Dentist | 2147, Northdale Blvd Nw., Coon Rapids, MN 55433 | 2010-10-13 |
| 1881914182 | Katie Daniels | Dentist | 8960 Springbrook Dr Nw Ste 150, Coon Rapids, MN 55433-5809 | 2010-06-09 |
| 1407085814 | Gina Lorraine Andersland | Dentist | 2519 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-3952 | 2009-07-07 |
| 1063576767 | Robert Sylvester Breitbach | Dentist | 2519 Coon Rapids Blvd, Coon Rapids, MN 55433 | 2006-12-20 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on MODERN DENTAL PROFESSIONALS, MN PC.
| 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.