MAIN STREET DENTAL CLINIC OF MANKATO, PLLP (NPI# 1285032243) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285032243 |
| Entity Type | Organization |
| Organization Name | MAIN STREET DENTAL CLINIC OF MANKATO, PLLP |
| Practice Address |
287 St Andrews Drive 100 Mankato MN 56001 |
| Mailing Address |
287 St Andrews Drive 100 Mankato MN 56001-8584 |
| Practice Telephone | 5077200250 |
| Mailing Telephone | 5077200250 |
| Enumeration Date | 2014-12-08 |
| Last Update Date | 2014-12-08 |
| Authorized Official Name | DR. CHAD MICHAEL HANSON (CFO) |
| Authorized Official Telephone | 5075832141 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 12942 | MN | Dental Providers |
| Street Address |
287 ST ANDREWS DRIVE 100 |
| City | MANKATO |
| State | MN |
| Zip Code | 56001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| 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 |
|---|---|---|---|---|
| 1912212606 | Modern Dental Professionals Minnesota PC | Dentist | 530 West Pleasant, Mankato, MN 56001 | 2010-08-18 |
| 1073740593 | Christopher K Meehan | Dentist | 151 Saint Andrews Ct Ste 1120, Mankato, MN 56001-8819 | 2009-06-11 |
| 1962613638 | William E Dobbs | Dentist | 309 Holly Ln Ste 101, Mankato, MN 56001-6276 | 2007-05-24 |
| 1912059072 | Garrett Starr | Dentist | 120 N Augusta Ct, Suite 108, Mankato, MN 56001-8707 | 2007-01-17 |
| 1831288463 | James Daniel Connors | Dentist | 201 North Broad St, Suite 204, Mankato, MN 56001 | 2006-10-12 |
| 1003907122 | Douglas Wilford Burgess | Dentist | 730 Madison Avenue, Mankato, MN 56001 | 2006-09-27 |
| 1275636615 | Tom L Pooley | Dentist | 124 E Walnut St, Ste 300, Mankato, MN 56001 | 2006-09-07 |
| 1184726531 | Douglas W Burgess Dds Pa | Dentist | 730 E Madison Ave, Mankato, MN 56001-6100 | 2006-09-05 |
| 1508878604 | James Paul Knudson | Dentist | 730 Madison Ave, Mankato, MN 56001 | 2006-08-13 |
| 1912920059 | Madison Avenue Family Dental Center, Ltd | Dentist | 608 E Madison Ave, Mankato, MN 56001-6112 | 2006-07-26 |
| Find all providers in MANKATO | ||||
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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.