DEER RIVER DENTAL CLINIC (NPI# 1417464157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417464157 |
| Entity Type | Organization |
| Organization Name | DEER RIVER DENTAL CLINIC |
| Practice Address |
111 Main Street E Deer River MN 56636 |
| Mailing Address |
Po Box 40 Deer River MN 56636-0040 |
| Practice Telephone | 2182468200 |
| Mailing Telephone | 2182468200 |
| Mailing Fax Number | 2182468982 |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2018-01-03 |
| Authorized Official Name | JEFFREY LEE CCARTER (DENTIST/OWNER) |
| Authorized Official Telephone | 2182468200 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
D9499 | MN | Dental Providers |
| Street Address |
111 MAIN STREET E |
| City | DEER RIVER |
| State | MN |
| Zip Code | 56636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992251235 | Ashley Ann Seedorf | Counselor | 313 Main Avenue, Deer River, MN 56636 | 2016-08-28 |
| 1376969675 | Thomas Kleinkauf | Family Medicine | 33688 East Point Rd, Deer River, MN 56636 | 2014-03-11 |
| 1073527651 | Brielle A Loe | Family Medicine | 300 West Conan St., Duluth Clinic-ely, Ely, MN 56636 | 2006-07-28 |
| 1619949328 | Jeffrey Lee Carter | Dentist | 111 Main Street, Deer River, MN 56636 | 2006-02-06 |
| 1811425895 | Leah Hildebrandt | Dentist | 111 Main St, Po Box 40, Deer River, MN 56636 | 2017-06-02 |
| 1689739435 | Independent School District No 317 | Local Education Agency (LEA) | 101 1st Ave Ne, Deer River, MN 56636-0307 | 2006-12-22 |
| 1144794793 | Michaela Ashlyn Fairbanks | Specialist/Technologist | 44711 County Road 18, Deer River, MN 56636-2148 | 2019-01-16 |
| 1407153158 | Judy Louise Lemieux | Chiropractor | 37958 Amen Lake Rd, Deer River, MN 56636-3064 | 2011-02-15 |
| 1043554702 | Rodney C Horgen | Chiropractor | 37958 Amen Lake Rd, Deer River, MN 56636-3064 | 2012-11-19 |
| 1679730220 | Deer River Hired Hands, Inc. | Day Training, Developmentally Disabled Services | 309 3rd Ave Se, Deer River, MN 56636-8617 | 2008-05-21 |
| Find all providers in zip 56636 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071199 | Dental Specialist of Minnesota, Pllc | Dentist | 18258 Minnetonka Blvd Ste 100, Wayzata, MN 55391-3324 | 2020-07-29 |
| 1215588660 | The Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2019-09-26 |
| 1780236539 | Modern Care Endodontics of Apple Valley | Dentist | 15160 Foliage Ave Ste 100, Apple Valley, MN 55124-5916 | 2019-07-11 |
| 1699268052 | Christopher Rex Lai | Dentist | 8-166 Moos Health Sciene Tower, 515 Delaware St. Se, Minneapolis, MN 55455 | 2018-06-11 |
| 1699272427 | Group Health Plan Inc | Dentist | 5500 Excelsior Blvd, St Louis Park, MN 55416-2935 | 2018-04-09 |
| 1225533037 | Younghyup Byun | Dentist | 1900 Kruchten Ct S Ste 100, Sartell, MN 56377-4731 | 2018-03-26 |
| 1275034886 | Great River Endodontics | Dentist | 9381 Cedar St., Monticello, MN 55362 | 2018-02-28 |
| 1174045975 | The Dental Specialists of Minnesota, Pllc | Dentist | 4640 Nicols Rd Ste 202, Eagan, MN 55122-7400 | 2017-07-13 |
| 1861914061 | The Dental Specialist of Minnesota, Pllc | Dentist | 2550 University Ave W Ste 155s, Saint Paul, MN 55114-1098 | 2017-07-10 |
| 1386189272 | Wayzata Endodontics, P.a. | Dentist | 101 Lake Street West, Suite 100, Wayzata, MN 55391 | 2016-12-30 |
| Find all providers with the same taxonomy | ||||
| City | DEER RIVER |
| Zip Code | 56636 |
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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.