LUCKY VANG


Address: 2228 E Lake St, Minneapolis, MN 55407-4321
Phone: 6128863270

LUCKY VANG (NPI# 1134637143) 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) 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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 125J00000X Dental Therapist DT71 MN Dental Providers

Other Providers LUCKY VANG

NPI Name Taxonomy Address Enumeration
1053627364 Lucky Vang Surgery 300 S Bruce St, Marshall, MN 56258-1934 2010-08-24

Office Location

Street Address 2228 E LAKE ST
City MINNEAPOLIS
State MN
Zip Code 55407-4321

Providers in the same location

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

Providers in the same zip code

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 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
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

Competitor

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City MINNEAPOLIS
Zip Code 55407

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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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