ANNALISE WALLERICH


Address: 2232 Hennepin Ave, Minneapolis, MN 55405-2737
Phone: 6123776108

ANNALISE WALLERICH (NPI# 1033729033) 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) 1033729033
Entity Type Individual
Full Name ANNALISE WALLERICH
Credential RDH, DT
Practice Address 2232 Hennepin Ave
Minneapolis
MN 55405-2737
Practice Telephone 6123776108
Mailing Telephone 6123776108
Enumeration Date 2020-08-04
Last Update Date 2020-08-04
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 125J00000X Dental Therapist DT134 MN Dental Providers

Office Location

Street Address 2232 HENNEPIN AVE
City MINNEAPOLIS
State MN
Zip Code 55405-2737

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558383679 Adele Della Torre Dentist 2232 Hennepin Ave, Minneapolis, MN 55405-2737 2006-07-25
1679962708 Verny Martinez Dental Therapist 2232 Hennepin Ave, Minneapolis, MN 55405-2737 2015-01-13
1679911531 Adt Kids Dental Services Pa Dentist 2232 Hennepin Ave, Minneapolis, MN 55405-2737 2013-06-12
1659393783 Alice M. Ottavi Dentist 2232 Hennepin Ave, Minneapolis, MN 55405-2737 2006-07-25
1548282585 Adt Dental, Ltd. Dentist 2232 Hennepin Ave, Minneapolis, MN 55405-2737 2006-07-25

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1003373689 Minneapolis Health & Wellness Ne, LLC Physical Therapist 2125 E Hennepin Ave, Suite 300, Minneapolis, MN 55405 2019-03-01
1033673967 Amy Fitzgerald Counselor 2915 South Wayzata Boulevard, Minneapolis, MN 55405 2019-01-24
1861975245 Sara Tejani Dentist 2232 Hennepin Ave. S., Minneapolis, MN 55405 2018-09-11
1477903995 James Albert Zeese Jr. Psychiatry & Neurology 2401 Laurel Avenue, Minneapolis, MN 55405 2016-06-15
1154786523 Sophia Bouwens Acupuncturist 275 Market St Ste 409, Minneapolis, MN 55405 2015-12-29
1912362732 Anna Needham Acupuncturist 2200 Hennepin Ave S, Minneapolis, MN 55405 2015-12-21
1821423740 Aja Dionna King Counselor 227 Colfax Ave N Ste 15, Minneapolis, MN 55405 2013-09-10
1013280403 Walgreen Co. Durable Medical Equipment & Medical Supplies 2100 Lyndale Ave S Ste A, Minneapolis, MN 55405 2012-02-15
1396022117 Sharri Peterson Rogers Marriage & Family Therapist 2809 South Wayzata Blvd, Minneapolis, MN 55405 2011-11-08
1447577143 Kareem Shareef Braxton Counselor 227 Colfax Avenue North, Suite 130, Minneapolis, MN 55405 2010-04-21
Find all providers in zip 55405

Taxonomy Information

Taxonomy Code 125J00000X
Grouping Dental Providers
Classification Dental Therapist

Taxonomy Definition

A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations.
Notes: Source: Summarized from Minnesota Statute 150A.105. [7/1/2012: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1003230137 Janelle Jehn Dental Therapist 4342 4th Ave S, Minneapolis, MN 55409-2155 2014-02-10
1568074607 Abdulkadir Egeh Dental Therapist 636 Broadway St Ne, Minneapolis, MN 55413-2164 2020-08-19
1679033252 Sheli Kaye Parkison Dental Therapist 4243 4th Ave S, Minneapolis, MN 55409-2113 2019-03-21
1386146942 Julie Marie Klemond Dental Therapist 2001 Bloomington Ave, Minneapolis, MN 55404-3074 2018-02-28
1073013322 Nicole Mathew Dental Therapist 636 Broadway St Ne, Minneapolis, MN 55413-2164 2018-02-13
1134637143 Lucky Vang Dental Therapist 2228 E Lake St, Minneapolis, MN 55407-4321 2018-01-12
1891233748 Jenny Meyers Dental Therapist 4243 4th Ave S, Minneapolis, MN 55409-2113 2017-02-10
1679962708 Verny Martinez Dental Therapist 2232 Hennepin Ave, Minneapolis, MN 55405-2737 2015-01-13
1114315678 Teresa Bushnell Dental Therapist 636 Broadway St Ne, Minneapolis, MN 55413-2164 2015-01-06
1124416789 Trina Courtright Dental Therapist 636 Broadway St Ne, Minneapolis, MN 55413-2164 2015-01-06
Find all providers in MINNEAPOLIS

Competitor

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City MINNEAPOLIS
Zip Code 55405

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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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