DR. MARCUS MICHAEL GUSTAFSON (NPI# 1164489654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164489654 |
| Entity Type | Individual |
| Full Name | DR. MARCUS MICHAEL GUSTAFSON |
| Credential | DDS |
| Practice Address |
16678 7th St S Lakeland MN 55043-9531 |
| Practice Telephone | 6128676177 |
| Mailing Telephone | 6128676177 |
| Enumeration Date | 2006-04-27 |
| Last Update Date | 2015-10-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D8384 | MN | Dental Providers |
| Street Address |
16678 7TH ST S |
| City | LAKELAND |
| State | MN |
| Zip Code | 55043-9531 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750854741 | Debra Sue Chmieleski | Counselor | 16383 Upper 22 Nd Street South, St. Croix Beach, MN 55043 | 2019-01-02 |
| 1306096433 | David Duane Millard | Physical Therapist | 16051 Quality Court, Lakeland, MN 55043 | 2008-09-25 |
| 1174795009 | Adena LLC | Home Health | 78 St. Croix Trail S, Suite 120, Lakeland, MN 55043 | 2008-04-01 |
| 1265499743 | John Edward Sweeney | Dentist | 44 South St Croix Trail, Suite 100, Lakeland, MN 55043 | 2006-04-27 |
| 1225200439 | Daniel D Porter | Chiropractor | 326 Saint Croix Trail South, Lakeland, MN 55043-0294 | 2008-03-27 |
| 1629208558 | John Burton Young Jr. | Otolaryngology | 2787 Itasca Ave., St. Mary's Pt., MN 55043-0325 | 2009-07-27 |
| 1730278276 | Tamara Quinlan Caulder | Chiropractor | 44 Saint Croix Trl S, Suite 200, Lakeland, MN 55043-8404 | 2006-10-12 |
| 1932547692 | Robin Lee Fate | Counselor | 44 Saint Croix Trl S, St. Croix Business Center, Suite 155, Lakeland, MN 55043-8404 | 2013-06-04 |
| 1912169087 | Afton Chiropractic Clinic | Chiropractor | 44 Saint Croix Trl S, Suite 200, Lakeland, MN 55043-8404 | 2008-06-30 |
| 1306040381 | Afton Chiropractic Clinic Pa | Acupuncturist | 44 Saint Croix Trl S, Suite 200, Lakeland, MN 55043-8404 | 2007-06-13 |
| Find all providers in zip 55043 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407344435 | Dentists of Lakeland, Pa | Dentist | 3700 Us Highway 98 N Ste 105, Lakeland, FL 33809-3809 | 2018-04-25 |
| 1235649518 | Lakeland Modern Dentistry, Pa | Dentist | 4620 S Florida Ave Ste 120, Lakeland, FL 33813-2166 | 2017-10-02 |
| 1316497134 | Dental Associates of Florida (s. Lakeland) Pllc | Dentist | 444 W Pipkin Rd, Lakeland, FL 33813-2612 | 2016-10-05 |
| 1023564903 | Georges Raffoul | Dentist | 2744 South Florida Ave, Lakeland, FL 33584 | 2016-08-30 |
| 1295289171 | Kendrah Lynn Harper | Dentist | 600 W Peachtree St, Lakeland, FL 33815-1504 | 2016-08-09 |
| 1033560586 | Charles D. Llano, D.d.s. | Dentist | 320 West Highland Drive, Lakeland, FL 33813 | 2016-06-27 |
| 1144605320 | Austin Jordan Davis | Dentist | 8950 Us Highway 64 Ste 108, Lakeland, TN 38002-4566 | 2015-07-29 |
| 1407105083 | Elena Kan | Dentist | 5644 Vintage View Boulevard, Lakeland, FL 33812 | 2012-08-29 |
| 1174827901 | Affordable Dentures - Lakeland, P.a. | Dentist | 3615 S Florida Ave Ste 1230, Lakeland, FL 33803-4808 | 2011-01-09 |
| 1407164502 | Shannon Holer Kelso | Dentist | 2156 Harden Blvd., Lakeland, FL 33803 | 2010-09-23 |
| Find all providers in LAKELAND | ||||
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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.