INSIDE EDGE DENTAL PLLC (NPI# 1114360492) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114360492 |
| Entity Type | Organization |
| Organization Name | INSIDE EDGE DENTAL PLLC |
| Other Organization Name | EAST DENTAL |
| Practice Address |
1346 Payne Ave Saint Paul MN 55130-3434 |
| Practice Telephone | 6517746085 |
| Practice Fax Number | 6517742660 |
| Mailing Telephone | 6517746085 |
| Mailing Fax Number | 6517742660 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2017-02-02 |
| Authorized Official Name | JENNIFER A MARKER JOHNSON (DDS/PRESIDENT) |
| Authorized Official Telephone | 6517746085 |
| 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 |
|---|---|
| East Dental | Doing Business As Name - Organization |
| Street Address |
1346 PAYNE AVE |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55130-3434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043295132 | Douglas Glen Walesheck | Dentist | 1346 Payne Ave, Saint Paul, MN 55101-3434 | 2005-12-12 |
| 1982673570 | Jennifer Ann Marker Johnson | Dentist | 1346 Payne Ave, Saint Paul, MN 55130-3450 | 2006-03-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904587 | Confident Care LLC | In Home Supportive Care | 1040 Arkwright Street, Saint Paul, MN 55130 | 2018-09-01 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1174865570 | Sarang Patel | Internal Medicine | 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 | 2013-03-23 |
| 1427394501 | Zongxee Lee | Registered Nurse | 1072 Payne Ave, St. Paul, MN 55130 | 2012-12-18 |
| 1740532753 | One Stop Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1049 Payne Ave Suite C, St Paul, MN 55130 | 2012-10-15 |
| 1689923997 | Alexis Simmons | Counselor | 402 University Ave East, Suite A-127, Saint Paul, MN 55130 | 2012-08-31 |
| 1689804064 | Group Health Plan, Inc. | Durable Medical Equipment & Medical Supplies | 537 Phalen Blvd, Saint Paul, MN 55130 | 2009-07-21 |
| 1477756534 | Chad Everett Christensen | Chiropractor | 1073 Payne Ave, Saint Paul, MN 55130 | 2007-06-07 |
| 1922219021 | Qwik Urgent Care Clinic | Family Medicine | 1239 Payne Avenue, Saint Paul, MN 55130 | 2007-05-24 |
| 1275743981 | Yia Vang | Technician | 1100 Arkwright St., St. Paul, MN 55130 | 2007-05-23 |
| Find all providers in zip 55130 | ||||
| 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 |
|---|---|---|---|---|
| 1831614387 | David Ji Hyun Park | Dentist | 393 Dunlap St N Ste 308, Saint Paul, MN 55104-4223 | 2017-08-06 |
| 1205289428 | Chukwujindu Onyemordi Nwaigbo | Dentist | 476 Herschel St, Apt 1, Saint Paul, MN 55104-3608 | 2016-07-22 |
| 1427302983 | Ali Barbarawi | Dentist | 1200 Robert St S, Saint Paul, MN 55118-2308 | 2012-11-06 |
| 1801029293 | Family First Dental Associates of West Point, P.C. | Dentist | 809 6th St, Saint Paul, NE 68873-1604 | 2009-09-01 |
| 1942470539 | Michael A. Kurkowski, Pa | Dentist | 3500 Rice St, Saint Paul, MN 55126-3043 | 2008-03-10 |
| 1841317732 | Mark I. Malterud, D.d.s., P.a. | Dentist | 770 Mount Curve Blvd, Saint Paul, MN 55116-1165 | 2007-03-23 |
| 1124172754 | Thomas Elliot Vukodinovich | Dentist | 542 Snelling Ave S, Saint Paul, MN 55116-1565 | 2007-01-22 |
| 1699825612 | Lezlie Ann Nelson | Dentist | 375 Jackson St Ste 200, Saint Paul, MN 55101-1806 | 2007-01-11 |
| 1174671358 | Lynn Robert Ostlund | Dentist | 1043 Payne Ave, Saint Paul, MN 55101-3840 | 2007-01-06 |
| 1295890895 | Cherokee Dental, P.a. | Dentist | 374 Annapolis St W, Saint Paul, MN 55118-1107 | 2006-12-25 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55130 |
Please comment or provide details below to improve the information on INSIDE EDGE DENTAL PLLC.
| 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.