SOUTHRIDGE DENTAL, PA (NPI# 1386166734) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386166734 |
| Entity Type | Organization |
| Organization Name | SOUTHRIDGE DENTAL, PA |
| Practice Address |
1320 Mendota Rd Inver Grove Heights MN 55077-1255 |
| Practice Telephone | (651) 451-1884 |
| Practice Fax Number | 6513069709 |
| Mailing Telephone | 6514511884 |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2017-07-07 |
| Authorized Official Name | SHERYL BOTTJEN TANDON (DENTIST) |
| Authorized Official Telephone | 6514511884 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | D12847 | MN | Dental Providers |
| Street Address |
1320 MENDOTA RD |
| City | INVER GROVE HEIGHTS |
| State | MN |
| Zip Code | 55077-1255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609865286 | Michael J Dillon | Dentist | 1320 Mendota Rd, Inver Grove Heights, MN 55077-1255 | 2005-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679194229 | Suite Living Senior Care of Inver Grove Heights | Assisted Living Facility | 7900 Austin Way, Inver Grove Heights, MN 55077 | 2020-05-05 |
| 1801325402 | Marnie Tuenge | Counselor | 4890 Ashley Lane, 301, Inver Grove Heights, MN 55077 | 2017-06-07 |
| 1104172576 | Amanda Lefler | Pharmacist | 7841 Amana Trail, Inver Grove Heights, MN 55077 | 2012-08-03 |
| 1568743474 | Jw Advantage Care, LLC | Home Health | 1870- 50th Street E., Suite 7, Inver Grove Heights, MN 55077 | 2011-09-06 |
| 1255625737 | Greathomemn | Assisted Living Facility | 8668 A;lvarado Court, Inver Grove Heights, MN 55077 | 2011-06-02 |
| 1760794580 | Inver Grove Heights Wp II, LLC | Alzheimer Center (Dementia Center) | 9058 Buchanan Trail, Inver Grove Heights, MN 55077 | 2010-07-09 |
| 1083847610 | Inverwood Senior Living LLC | Assisted Living Facility | 7260 So. Robert Trail, Inver Grove Heights, MN 55077 | 2009-08-31 |
| 1366822587 | Andrea Elizabeth Larson | Family Medicine | 5625 Cenex Dr, Inver Grove Heights, MN 55077 | 2015-06-03 |
| 1922485598 | Elizabeth Price | Family Medicine | 5625 Cenex Dr, Inver Grove Heights, MN 55077 | 2015-05-01 |
| 1811316730 | Abdirizak Nuno | Psychiatry & Neurology | 5625 Cenex Dr, Inver Grove Heights, MN 55077 | 2014-04-08 |
| Find all providers in zip 55077 | ||||
| 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 |
|---|---|---|---|---|
| 1508109810 | Vladimir Leon Salazar | Dentist | 5870 Blackshire Path, Inver Grove Heights, MN 55076-1620 | 2013-04-04 |
| 1194820498 | Brian Kraby | Dentist | 9042 Cahill Ave, Inver Grove Heights, MN 55076-3543 | 2006-09-13 |
| 1891777454 | Carrie Buerman Peroutka | Dentist | 6105 Cahill Ave E, Inver Grove Heights, MN 55076-1525 | 2005-11-18 |
| 1013999309 | Patricia B Ura | Dentist | 6105 Cahill Ave, Inver Grove Heights, MN 55076-1525 | 2005-11-14 |
| 1942282231 | Bradley Duane Swingdorf | Dentist | 6105 Cahill Avenue East, Inver Grove Heights, MN 55076-1308 | 2005-11-14 |
| 1821079583 | G2 South | Dentist | 5846 Blackshire Path, Inver Grove Heights, MN 55016 | 2005-11-09 |
| 1295343952 | Tanner Berg | Dentist | 5350 S Robert Trl, Inver Grove Heights, MN 55077-1404 | 2020-07-20 |
| 1336705136 | Anna Marie Francke | Dentist | 6105 Cahill Ave, Inver Grove Heights, MN 55076-1525 | 2019-05-16 |
| 1700376969 | Tara Skelly Peterson | Dentist | 9042 Cahill Ave, Inver Grove Heights, MN 55076-3543 | 2018-05-14 |
| 1619350006 | Katherine Rose Vaughan | Dentist | 5625 Cenex Dr, Inver Grove Heights, MN 55077-1724 | 2015-07-02 |
| Find all providers in INVER GROVE HEIGHTS | ||||
| City | INVER GROVE HEIGHTS |
| Zip Code | 55077 |
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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.