GROVE DENTIST PA (NPI# 1326481284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326481284 |
| Entity Type | Organization |
| Organization Name | GROVE DENTIST PA |
| Practice Address |
13649 Grove Dr Maple Grove MN 55311-4405 |
| Practice Telephone | 7634208038 |
| Practice Fax Number | 7634944222 |
| Mailing Telephone | 7634208038 |
| Mailing Fax Number | 7634944222 |
| Enumeration Date | 2013-04-10 |
| Last Update Date | 2013-04-10 |
| Authorized Official Name | DR. RENY CHACKO (DENTIST) |
| Authorized Official Telephone | 6513082804 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D11844 | MN | Dental Providers |
| Street Address |
13649 GROVE DR |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55311-4405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609391374 | Deborah Lynn Higgins | Foster Care Agency | 8288 Revelwood Place, Maple Grove, MN 55311 | 2017-08-03 |
| 1013457993 | Trillium Chiropractic & Wellness Pa | Chiropractor | 13700 Reimer Dr Suite 250, Maple Grove, MN 55311 | 2017-02-27 |
| 1720535263 | Fischer Vision PC | Optometrist | 13334 Bass Lake Road North, Maple Grove, MN 55311 | 2016-09-01 |
| 1033571062 | Iman Dadras Konestani | Marriage & Family Therapist | 9325 Garland Lane N Apt 108, Mapple Grove, MN 55311 | 2016-03-29 |
| 1902272685 | Todd Archbold | Social Worker | 18153 80th Pl N, Maple Grove, MN 55311 | 2015-08-17 |
| 1144634395 | Petersen Chiropractic Inc. | Chiropractor | 9505 Blackoaks Ln No., Maple Grove, MN 55311 | 2014-06-16 |
| 1972738276 | Sara Jean Bidler | Marriage & Family Therapist | 7026 E Fish Lake Rd, Maple Grove, MN 55311 | 2009-05-16 |
| 1962670026 | Helminger Chiropractic, P.a. | Chiropractor | 9479 Garland Lane North, Maple Grove, MN 55311 | 2008-02-12 |
| 1457579450 | Cynthia C Cassel | Physician Assistant | 6300 Wedgewood Way, Maple Grove, MN 55311 | 2007-04-23 |
| 1386860732 | Thomas Triden | Chiropractor | 7494 East Fish Lake Road, Maple Grove, MN 55311 | 2007-04-17 |
| Find all providers in zip 55311 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942793989 | Lyle Arrian Corpuz Carlos | Dentist | 12737 Elm Creek Blvd N, Maple Grove, MN 55369-7045 | 2018-06-13 |
| 1346770500 | Hyeok Je Lee | Dentist | 6240 Quinwood Ln N # 100, Maple Grove, MN 55369-6384 | 2017-06-19 |
| 1396129433 | Maple Grove Smiles Dentistry, PC | Dentist | 12775 Elm Creek Blvd N, Maple Grove, MN 55369 | 2015-07-18 |
| 1619259181 | Cedar Island Dental | Dentist | 7378 Kirkwood Ct N, Maple Grove, MN 55369-5270 | 2011-09-12 |
| 1417240243 | Jennifer Marie Bertrand | Dentist | 7270 Forestview Ln N Ste 250, Maple Grove, MN 55369-5605 | 2011-05-26 |
| 1740508704 | Partners In Dentistry Ltd | Dentist | 17143 73rd Pl N, Maple Grove, MN 55311-2686 | 2010-05-13 |
| 1639337710 | Blue Ridge Dental Center Pa | Dentist | 13800 83rd Way N Ste 100, Maple Grove, MN 55369-7016 | 2008-05-27 |
| 1699977058 | Jodi Marie Burth | Dentist | 11256 86th Ave N, Maple Grove, MN 55369 | 2007-06-05 |
| 1124230800 | Matthew P Dale Dds Pa | Dentist | 13998 Maple Knoll Way # Ll103, Maple Grove, MN 55369-7004 | 2007-05-04 |
| 1538389093 | Michael Lawrence Colbert | Dentist | 10182 Lancaster Ln N, Maple Grove, MN 55369-3562 | 2007-04-26 |
| Find all providers in MAPLE GROVE | ||||
| City | MAPLE GROVE |
| Zip Code | 55311 |
Please comment or provide details below to improve the information on GROVE DENTIST PA.
| 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.