RIVERDALE KIDDS PEDIATRIC DENTISTRY, PLLC (NPI# 1477025906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477025906 |
| Entity Type | Organization |
| Organization Name | RIVERDALE KIDDS PEDIATRIC DENTISTRY, PLLC |
| Practice Address |
3585 124th Ave Nw Ste 400 Coon Rapids MN 55433-1008 |
| Practice Telephone | 7632835494 |
| Mailing Telephone | 7637671524 |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2018-12-21 |
| Authorized Official Name | DEANN CARLSON (FINANCIAL COORDINATOR) |
| Authorized Official Telephone | 7632835494 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
3585 124TH AVE NW STE 400 |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433-1008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770134793 | Shelley Karee Peterson | Technician | 10311 Bittersweet St Nw, Coon Rapids, MN 55433 | 2019-09-20 |
| 1578122057 | Courtney Gau | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Dr. Nw, Coon Rapids, MN 55433 | 2019-06-10 |
| 1992275606 | Maliki Fofee Kamara | Licensed Practical Nurse | 2451 109th Ave Nw Apt. 1, Coon Rapids, MN 55433 | 2018-11-26 |
| 1992284541 | Sarah Vennes | Massage Therapist | 6400 Flying Cloud Dr, Suite 240, Eden Prairie, MN 55433 | 2018-08-13 |
| 1538646609 | Paige Prince | Behavior Technician | Fraser Coon Rapids, 9120 Springbrook Drive Nw, Coon Rapids, MN 55433 | 2018-07-23 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1235642513 | Vista Family Eye Care LLC | Optometrist | 9920 Foley Blvd Nw Ste 120, Coon Rapids, MN 55433 | 2017-11-09 |
| 1538697818 | Mohammed Nmn Ahmed | Internal Medicine | 9055 Spring Brook Drive, Allina Coon Rapids Clinic 9055, Coon Rapids, MN 55433 | 2017-05-31 |
| 1639531353 | Journi LLC | Nurse Practitioner | 277 Coon Rapids Blvd Suite 308, Coon Rapids, MN 55433 | 2016-03-22 |
| 1821457722 | Honorine Boyce | Licensed Practical Nurse | 2743 111th Ave. Nw, Coon Rapids, MN 55433 | 2016-02-19 |
| Find all providers in zip 55433 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639126683 | Darcy Jay Rindelaub | Dentist | 3585 124th Ave Nw, Suite 400, Coon Rapids, MN 55433-1006 | 2006-05-27 |
| 1053690198 | Riverdale Pediatric Dentistry P.a. | Dentist | 3585 124th Ave Nw, Ste 400, Coon Rapids, MN 55433-1006 | 2011-08-07 |
| 1700816634 | Michelle L Meiser | Dentist | 3585 124th Ave Nw, Ste 400, Coon Rapids, MN 55433-1006 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467924290 | Camp Smile Pediatric Dentistry Excelsior Pllc | Dentist | 675 Water St Ste 2, Excelsior, MN 55331-3072 | 2018-12-18 |
| 1932671765 | Camp Smile Pediatric Dentistry Chaska | Dentist | 111 Hundertmark Rd Ste 304n, Chaska, MN 55318-1587 | 2018-12-18 |
| 1538678057 | Blaine Kidds Pediatric Dentistry Pllc | Dentist | 1351 113th Ave Ne, Blaine, MN 55434-3874 | 2017-09-27 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1710367925 | Lindsay Bedeaux | Dentist | 7373 France Ave S Ste 400, Edina, MN 55435-4549 | 2015-06-02 |
| 1609272822 | Rochester Pediatric Dentistry LLC | Dentist | 1705 S Boradway Ave Ste B, Rochester, MN 55904-7960 | 2014-11-16 |
| 1396186813 | Central Minnesota Pediatric Dentists Pa | Dentist | 507 N Nokomis St Ste C, Alexandria, MN 56308-2353 | 2013-07-12 |
| 1265873707 | Central Minnesota Pediatric Dentists Pa | Dentist | 570 Humboldt Dr Ste 102, Big Lake, MN 55309-4844 | 2013-07-12 |
| 1013264621 | Northland Dental Partners | Dentist | 3507 Round Lake Blvd. Suite 900, Anoka, MN 55303 | 2012-08-14 |
| 1407131618 | St. Croix Kidds Pediatric Dentistry | Dentist | 4951 Morehead Ave, White Bear Lake, MN 55110-2633 | 2011-10-19 |
| Find all providers with the same taxonomy | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
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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.