ANDREW HALVERSON (NPI# 1295266476) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1295266476 |
Entity Type | Individual |
Full Name | ANDREW HALVERSON |
Credential | MDT |
Practice Address |
450 Syndicate St N #300 Saint Paul MN 55104-4107 |
Mailing Address |
2651 Innsbruck Ct New Brighton MN 55112-6364 |
Practice Telephone | 6512547374 |
Enumeration Date | 2017-03-21 |
Last Update Date | 2017-03-21 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 125J00000X | Dental Therapist | 82 | MN | Dental Providers |
Street Address |
450 SYNDICATE ST N #300 |
City | SAINT PAUL |
State | MN |
Zip Code | 55104-4107 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366543829 | Julie Foley | Physical Therapist | 450 Syndicate St N, Saint Paul, MN 55104-4107 | 2006-09-26 |
1780024331 | Katherine Dee Cunningham | Counselor | 450 Syndicate St N, Saint Paul, MN 55104-4107 | 2013-06-27 |
1750654588 | Crystal Ann Baker | Dental Hygienist | 450 Syndicate St N, Saint Paul, MN 55104-4107 | 2012-02-09 |
1043407737 | Xiong Vue | Social Worker | 450 Syndicate St N, Suite 285, Saint Paul, MN 55104-4107 | 2007-09-27 |
1295853877 | Thaly Cavanaugh | Social Worker | 450 Syndicate St N, #285, Saint Paul, MN 55104-4107 | 2007-03-26 |
1699810002 | Marlyn Charles Comes | Chiropractor | 450 Syndicate St N, # 198, Saint Paul, MN 55104-4107 | 2007-02-21 |
1750436333 | Group Health Plan Inc | Dentist | 450 Syndicate St N, #300, Saint Paul, MN 55104-4107 | 2007-01-24 |
1528115649 | Nina D Thai | Dentist | 450 Syndicate St N, Suite 119, Saint Paul, MN 55104-4107 | 2007-01-03 |
1588725055 | Julie Lynn Gagne | Social Worker | 450 Syndicate St N, Suite 5, Saint Paul, MN 55104-4107 | 2006-12-12 |
1902971047 | Paul Sinclair | Social Worker | 450 Syndicate St N, Ste 285, Saint Paul, MN 55104-4107 | 2006-11-22 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
Find all providers in zip 55104 |
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 |
---|---|---|---|---|
1588220677 | Scott Michael Danzl | Dental Therapist | 393 Dunlap St N Ste 308, Saint Paul, MN 55104-4223 | 2019-05-14 |
1538692595 | Jenna Johnson | Dental Therapist | 1790 7th St E, Saint Paul, MN 55119 | 2017-04-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487264446 | Amber Nichelle Irby | Dental Therapist | 903 W Center St #130, Rochester, MN 55902 | 2020-08-05 |
1558835942 | Jennifer Iacobelli | Dental Therapist | 13899 Highway 13 South Frontage Road, Savage, MN 55378 | 2019-01-18 |
1992288781 | Katie Ask | Dental Therapist | 13889 Highway 13 S, Frontage Rd, Savage, MN 55378 | 2018-09-08 |
1487154092 | Sunny Moon | Dental Therapist | 10584 France Ave S, Bloomington, MN 55431-3538 | 2018-02-20 |
1326548454 | Julie Bonham | Dental Therapist | 803 3rd St. Se, Suite 330, Little Falls, MN 56345 | 2018-02-15 |
1376077974 | Saritha Gajawada | Dental Therapist | 15354 Plumstone Dr, Eden Prairie, MN 55347-2061 | 2017-04-20 |
1649644063 | Brittany Gronland | Dental Therapist | 25730 Smithtown Rd, Excelsior, MN 55331-8592 | 2015-11-23 |
1124405857 | Jenna Susanne Marquardt | Dental Therapist | 209 South 1st Street, Montevideo, MN 56265 | 2015-05-01 |
1558751495 | Weston Mark Schmidt | Dental Therapist | 411 East Howard St., Jacobson Family Dentistry PC, Hibbing, MN 55746 | 2015-01-30 |
1003230137 | Janelle Jehn | Dental Therapist | 4342 4th Ave S, Minneapolis, MN 55409-2155 | 2014-02-10 |
Find all providers with the same taxonomy |
City | SAINT PAUL |
Zip Code | 55104 |
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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.