CHASKA PEDIATRIC DENTISTRY, P.A. (NPI# 1063834588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063834588 |
| Entity Type | Organization |
| Organization Name | CHASKA PEDIATRIC DENTISTRY, P.A. |
| Other Organization Name | TAILWIND PEDIATRIC DENTISTRY |
| Practice Address |
111 Hundertmark Rd Suite 304n Chaska MN 55318-4551 |
| Mailing Address |
250 Central Ave N Suite 113 Wayzata MN 55391-1206 |
| Practice Telephone | 9524753135 |
| Mailing Telephone | 9524753135 |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2014-01-17 |
| Authorized Official Name | TAYLOR STEPHENS (OWNER/PRESIDENT) |
| Authorized Official Telephone | 9524753135 |
| Authorized Official Credential | D.D.S |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D12818 | MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Tailwind Pediatric Dentistry | Doing Business As Name - Organization |
| Street Address |
111 HUNDERTMARK RD SUITE 304N |
| City | CHASKA |
| State | MN |
| Zip Code | 55318-4551 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093789257 | Carrie Ann Muench | Pediatrics | 111 Hundertmark Rd, #420, Chaska, MN 55318-1459 | 2006-02-15 |
| 1407461072 | Ridgeview Medical Center | Family Medicine | 111 Hundertmark Rd, Chaska, MN 55318-4551 | 2020-09-10 |
| 1396392130 | Megan Mattson | Pharmacist | 111 Hundertmark Rd, Chaska, MN 55318-4551 | 2019-08-26 |
| 1154873263 | Chaska Center Drug, PC | Pharmacy | 111 Hundertmark Rd, Suite 100, Chaska, MN 55318-4551 | 2016-10-25 |
| 1972956084 | Alexander Ross | Pharmacist | 111 Hundertmark Rd, Suite 115n, Chaska, MN 55318-4551 | 2016-07-13 |
| 1760843536 | Brooke Frances Chaudhary | Nurse Practitioner | 111 Hundertmark Rd, Suite 115n, Chaska, MN 55318-4551 | 2016-03-08 |
| 1831565829 | Mallory Flander | Counselor | 111 Hundertmark Rd, Chaska, MN 55318-4551 | 2015-08-13 |
| 1285012260 | Christopher Solie | Emergency Medicine | 111 Hundertmark Rd, Chaska, MN 55318-4551 | 2015-05-11 |
| 1932597424 | Sandra Hanson | Specialist/Technologist | 111 Hundertmark Rd, Suite 400, Chaska, MN 55318-4551 | 2015-01-06 |
| 1437564721 | Nolan Robert Gartin | Emergency Medicine | 111 Hundertmark Rd, Chaska, MN 55318-4551 | 2014-06-25 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548742968 | Elizabeth Ann Root | Counselor | 111 Hundertmark Rd Suite 450, Chaska, MN 55318 | 2018-09-01 |
| 1972002244 | Ruth Ann Plante | Counselor | 510 Chestnut Street Suite 201, Chaska, MN 55318 | 2018-02-01 |
| 1265959795 | Bhatti Gi Surgery Center LLC | Clinic/Center | 1447 White Oak Dr, Chaska, MN 55318 | 2017-08-25 |
| 1194241166 | Five Stars Recovery Center | Clinical Medical Laboratory | 1045 Stoughton Ave., Chaska, MN 55318 | 2017-08-21 |
| 1306383419 | Laurie Ann Sisser | Registered Nurse | 123 W. 3rd Street, Suite #1, Forever Life Home Health Care, Chaska, MN 55318 | 2017-01-26 |
| 1942756671 | David Erlandson | Physical Therapist | 110105 Pioneer Trail, #201, Chaska, MN 55318 | 2016-09-01 |
| 1912319286 | Chaska Commons Dental Group PC | Dentist | 114 Pioneer Trail, Chaska, MN 55318 | 2014-05-21 |
| 1063546620 | Laura Lee Bergjord | Social Worker | 600 East 4th St, Chaska, MN 55318 | 2007-03-15 |
| 1184758740 | Jennifer Ann Mueller | Social Worker | 401 East Fourth Street, Chaska, MN 55318 | 2007-03-15 |
| 1487785234 | The Salvation Army Harbor Light Center Beacon Program | Substance Abuse Rehabilitation Facility | 11065 Village Road, Chaska, MN 55318 | 2007-03-07 |
| Find all providers in zip 55318 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699204172 | Wld2, LLC | Clinic/Center | 132 Pioneer Trl, Chaska, MN 55318-1167 | 2017-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710025 | Theresa M. Snell | Clinic/Center | 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 | 2020-11-05 |
| 1376143248 | James M. Williams, D.d.s., P.a. | Clinic/Center | 620 Union St S, Mora, MN 55051-1818 | 2020-10-29 |
| 1235746058 | Asp Dental, PC | Clinic/Center | 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 | 2020-09-25 |
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1518574532 | Stillwater Family Dental | Clinic/Center | 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 | 2020-09-24 |
| 1093321531 | Barnett Dental Inc | Clinic/Center | 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 | 2020-09-21 |
| 1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
| 1770195158 | Mark T. Sherman Dds Pa | Clinic/Center | 31011 Rasmussen Rd, Pequot Lakes, MN 56472-1227 | 2020-08-18 |
| 1689286015 | Lifelong Dental Care | Clinic/Center | 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 | 2020-08-18 |
| 1528678497 | Custom Smiles Dentistry, Pllc | Clinic/Center | 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 | 2020-08-05 |
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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.