MRS. TERANI ROSE HARRIS (NPI# 1164706347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164706347 |
| Entity Type | Individual |
| Full Name | MRS. TERANI ROSE HARRIS |
| Credential | RDH, DT, ADT |
| Practice Address |
601 Highway 73 Floodwood MN 55736-8450 |
| Mailing Address |
2822 Silver Fox Cir Duluth MN 55811-5834 |
| Practice Telephone | 2184762969 |
| Mailing Telephone | 2184280869 |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2018-10-25 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 124Q00000X | Dental Hygienist | 11055-016 | WI | Dental Providers |
| N | 124Q00000X | Dental Hygienist | H8920 | MN | Dental Providers |
| Y | 125K00000X | Advanced Practice Dental Therapist | DT69 | MN | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4 W Highway 61, Esko, MN 557339701 | 2188798355 |
| Street Address |
601 HIGHWAY 73 |
| City | FLOODWOOD |
| State | MN |
| Zip Code | 55736-8450 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942290226 | Leo Russell Shockley Jr. | Dentist | 601 Highway 73, Floodwood, MN 55736-8450 | 2005-10-26 |
| 1710145222 | Joseph Adam Gregorich | Dentist | 601 Highway 73, Box 46, Floodwood, MN 55736 | 2008-05-30 |
| 1497853105 | James Richard Swanstrom | Dentist | 601 Highway 73, Scenic Rivers Dental, Floodwood, MN 55736 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538655345 | Neil Raymond Johnson | Assisted Living Facility | 11549 Pokonen Road, Floodwood, MN 55736 | 2018-07-04 |
| 1235397381 | Brenda Jean Hansen | Clinic/Center | 425 6th Avenue West, Floodwood, MN 55736 | 2008-05-27 |
| 1205991163 | Ind School Dist 698 | Local Education Agency (LEA) | 115 West 4th Ave, Floodwood, MN 55736 | 2006-12-22 |
| 1801909932 | Floodwood Area Emergency Medical | Ambulance | 206 E 8th Ave, Floodwood, MN 55736 | 2006-08-15 |
| 1699748533 | Cook Area Health Services, Inc | Clinic/Center | 601 Hwy 73, Box 46, Floodwood, MN 55736-0046 | 2006-02-10 |
| 1508831843 | Antonio Timbol Toledo | Family Medicine | 126 W 5th Ave, Floodwood, MN 55736-0426 | 2006-02-21 |
| 1174596027 | Cook Area Health Services, Inc. | Clinic/Center | 126 W 7th Ave, Box 426, Floodwood, MN 55736-0426 | 2006-02-10 |
| 1801861174 | Dawn Christine Shafer | Nurse Practitioner | 126 W 7th Ave, Floodwood, MN 55736-0426 | 2006-02-21 |
| 1124322250 | Floodwood Area Emergency Medical Serv District | Ambulance | 206 E 8th Ave, Floodwood, MN 55736-0512 | 2011-01-04 |
| 1144608134 | Alicia Blair | Physical Therapist | 121 7th Ave W, Floodwood, MN 55736-1200 | 2015-05-11 |
| Find all providers in zip 55736 | ||||
| Taxonomy Code | 125K00000X |
| Grouping | Dental Providers |
| Classification | Advanced Practice Dental Therapist |
| An Advanced Practice Dental Therapist is: (1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or (2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum. The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations. |
| Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1144733130 | Lydia J Diekmann | Advanced Practice Dental Therapist | 2711 Broadway Ave Ste A00, Slayton, MN 56172-1313 | 2017-11-13 |
| 1073872503 | Brieanne Kelsey Borntrager | Advanced Practice Dental Therapist | 13899 Hwy 13 S Frnt Rd, Savage, MN 55378-2135 | 2012-05-03 |
| 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 |
| 1063953032 | Ashley Hueman | Advanced Practice Dental Therapist | 973 Skyline Dr Sw, Rochester, MN 55902-1220 | 2017-03-10 |
| 1124483656 | Tanu Dhoopar | Advanced Practice Dental Therapist | 3152 Minnehaha Ave, Minneapolis, MN 55406-1934 | 2015-12-29 |
| 1548631187 | Kaitlin Siewert | Advanced Practice Dental Therapist | 520 Main Street, Hawley, MN 56549 | 2015-10-08 |
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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.