LUCKY VANG (NPI# 1134637143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134637143 |
Entity Type | Individual |
Full Name | LUCKY VANG |
Practice Address |
2228 E Lake St Minneapolis MN 55407-4321 |
Practice Telephone | 6128863270 |
Enumeration Date | 2018-01-12 |
Last Update Date | 2018-01-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 125J00000X | Dental Therapist | DT71 | MN | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1053627364 | Lucky Vang | Surgery | 300 S Bruce St, Marshall, MN 56258-1934 | 2010-08-24 |
Street Address |
2228 E LAKE ST |
City | MINNEAPOLIS |
State | MN |
Zip Code | 55407-4321 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912003203 | Saharla A Jama | Dentist | 2228 E Lake St, Minneapolis, MN 55407-4321 | 2006-09-15 |
1679944698 | Twincare Dental LLC | Dentist | 2228 E Lake St, Minneapolis, MN 55407-4321 | 2015-10-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720644057 | Amana Home Care | Home Health | 2833 13th Ave S Suite 118, Minneapolis, MN 55407 | 2019-05-13 |
1356802979 | Aaron Randy Pickrel | Student in an Organized Health Care Education/Training Program | 2800 Chicago Avenue, #250, Minneapolis, MN 55407 | 2019-03-27 |
1053881631 | Naimo Abdisalam | Registered Nurse | 1229 East Lake Street, Minneapolis, MN 55407 | 2018-11-27 |
1437639614 | Kelly Usitalo | Nurse Practitioner | 913 E 26th Street, Piper Building Suite 401, Minneapolis, MN 55407 | 2018-08-17 |
1952880346 | Allison Hall | Internal Medicine | Minneapolis Heart Institute, 920 E 28 St. #300, Minneapolis, MN 55407 | 2018-08-07 |
1780176370 | Rebekah Sand | Physical Therapist | 2800 Chicage Avenue S, Suite 102, Minneapolis, MN 55407 | 2018-05-31 |
1417448663 | Vivian T.c. Liu | Student in an Organized Health Care Education/Training Program | 2020 E 28th Street, Suite 104, Minneapolis, MN 55407 | 2018-05-23 |
1053802397 | Isuroon | Counselor | 1600 East Lake Street Suite 1, Minneapolis, Mpls, MN 55407 | 2018-05-22 |
1154811404 | Mohamed Mukhtar Ali | Dentist | 4700 Cedar Ave S, Minneapolis, MN 55407 | 2018-05-12 |
1396254280 | Erin Elizabeth Casper | Registered Nurse | 3621 Oakland Ave, Minneapolis, MN 55407 | 2017-09-25 |
Find all providers in zip 55407 |
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 |
---|---|---|---|---|
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 |
1033729033 | Annalise Wallerich | Dental Therapist | 2232 Hennepin Ave, Minneapolis, MN 55405-2737 | 2020-08-04 |
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 |
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 |
City | MINNEAPOLIS |
Zip Code | 55407 |
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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.