MICHELLE STORLIE (NPI# 1104256106) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104256106 |
Entity Type | Individual |
Full Name | MICHELLE STORLIE |
Credential | D.T. |
Practice Address |
1575 20th St Nw Suite 102 Faribault MN 55021-2930 |
Practice Telephone | 5073346433 |
Practice Fax Number | 5073340044 |
Mailing Telephone | 5073346433 |
Mailing Fax Number | 5073340044 |
Enumeration Date | 2013-11-13 |
Last Update Date | 2013-11-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 125J00000X | Dental Therapist | DT25 | MN | Dental Providers |
Street Address |
1575 20TH ST NW SUITE 102 |
City | FARIBAULT |
State | MN |
Zip Code | 55021-2930 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902931199 | Legacy Anesthesia Services, Pllc | Clinic/Center | 1575 20th St Nw, Suite 203, Faribault, MN 55021 | 2007-02-21 |
1023541695 | Carley Banks | Advanced Practice Dental Therapist | 1575 20th St Nw, Faribault, MN 55021 | 2017-04-10 |
1033642947 | Lauren Johnson | Advanced Practice Dental Therapist | 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 | 2017-04-07 |
1215479530 | Tareen Dermatology, Pa | Non-Pharmacy Dispensing Site | 1575 20th St Nw, Faribault, MN 55021-2930 | 2016-11-17 |
1073900718 | Angella Schaefer | Optometrist | 1575 20th St Nw, Suite 101, Faribault, MN 55021-2930 | 2015-04-21 |
1962840520 | Kathleen Baker Gerber | Dentist | 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 | 2013-06-05 |
1386924231 | Sound Sleep Centers | Clinic/Center | 1575 20th St Nw, Suite 209, Faribault, MN 55021-2930 | 2011-08-24 |
1174834022 | Misty Purfeerst | Optometrist | 1575 20th St Nw, Ste 101, Faribault, MN 55021-2930 | 2010-06-25 |
1306018544 | King Orthodontics Ltd | Clinic/Center | 1575 20th St Nw, Suite 202, Faribault, MN 55021-2930 | 2008-03-27 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548872831 | Kent William Lundstrom | Pharmacist | 612 4th Street Nw, Faribault, MN 55021 | 2020-08-19 |
1053957357 | M&t Sisters of Serendipity Pllc | Counselor | 212a Centralave, Faribault, MN 55021 | 2019-11-21 |
1639720485 | Reliable Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 200 8th Avenue Nw, Faribault, MN 55021 | 2019-09-24 |
1235663428 | Tanya Borchert | Social Worker | 100 State Avenue, Faribault, MN 55021 | 2017-04-14 |
1235589854 | Bashir Omar I | Interpreter | 2426 Park Ave # 309, Faribault, MN 55021 | 2016-06-14 |
1790150381 | Rainbow United Care Transportation LLC | Non-emergency Medical Transport (VAN) | 1738 Patrick Bay, Faribault, MN 55021 | 2015-12-08 |
1740625938 | Steven James Klapmeier | Family Medicine | 1101 Linden Lane, Mcfffrb Health Service, Faribault, MN 55021 | 2013-05-02 |
1528306040 | Discovery Public School of Faribault | Local Education Agency (LEA) | 126 8th St. Nw, Faribault, MN 55021 | 2013-01-17 |
1164790374 | Emmanuel Douah | Pharmacist | 612 4th Avenue Nw, Faribault, MN 55021 | 2011-12-02 |
1770873937 | Faribault Senior Living LLC | Assisted Living Facility | 843 Faribault Road, Faribault, MN 55021 | 2011-04-08 |
Find all providers in zip 55021 |
Taxonomy Code | 125J00000X |
Grouping | Dental Providers |
Classification | Dental Therapist |
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] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487264446 | Amber Nichelle Irby | Dental Therapist | 903 W Center St #130, Rochester, MN 55902 | 2020-08-05 |
1558835942 | Jennifer Iacobelli | Dental Therapist | 13899 Highway 13 South Frontage Road, Savage, MN 55378 | 2019-01-18 |
1992288781 | Katie Ask | Dental Therapist | 13889 Highway 13 S, Frontage Rd, Savage, MN 55378 | 2018-09-08 |
1487154092 | Sunny Moon | Dental Therapist | 10584 France Ave S, Bloomington, MN 55431-3538 | 2018-02-20 |
1326548454 | Julie Bonham | Dental Therapist | 803 3rd St. Se, Suite 330, Little Falls, MN 56345 | 2018-02-15 |
1376077974 | Saritha Gajawada | Dental Therapist | 15354 Plumstone Dr, Eden Prairie, MN 55347-2061 | 2017-04-20 |
1649644063 | Brittany Gronland | Dental Therapist | 25730 Smithtown Rd, Excelsior, MN 55331-8592 | 2015-11-23 |
1124405857 | Jenna Susanne Marquardt | Dental Therapist | 209 South 1st Street, Montevideo, MN 56265 | 2015-05-01 |
1558751495 | Weston Mark Schmidt | Dental Therapist | 411 East Howard St., Jacobson Family Dentistry PC, Hibbing, MN 55746 | 2015-01-30 |
1003230137 | Janelle Jehn | Dental Therapist | 4342 4th Ave S, Minneapolis, MN 55409-2155 | 2014-02-10 |
Find all providers with the same taxonomy |
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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.