FAMILY & COSMETIC GENTLE DENTISTRY, LTD (NPI# 1477112456) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477112456 |
| Entity Type | Organization |
| Organization Name | FAMILY & COSMETIC GENTLE DENTISTRY, LTD |
| Practice Address |
2147 Northdale Blvd Nw Coon Rapids MN 55433 |
| Practice Telephone | 6512093139 |
| Mailing Telephone | 6512093139 |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2019-06-12 |
| Authorized Official Name | MR. ROBERT LUTHER BODIN (OWNER/CEO) |
| Authorized Official Telephone | 9522249788 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 256415000 | 05 |
| Other Name | Type Code |
|---|---|
| 'Gentle Dentistry' | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235429267 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 1714 Cope Ave E, Maplewood, MN 55109-2664 | 2011-04-11 |
| 1750563227 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 13550 26th Ave N Ste 200, Plymouth, MN 55441-3650 | 2007-11-27 |
| 1306028279 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 1060 Highway 15 S, #84, Hutchinson, MN 55350-3157 | 2007-12-03 |
| 1548442411 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 8711 E Point Douglas Rd S, Cottage Grove, MN 55016-5000 | 2007-12-03 |
| 1982886859 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 97 85th Ave Nw, Coon Rapids, MN 55433-6022 | 2007-12-03 |
| 1942482815 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 3015 Highway 29 S, I1, Alexandria, MN 56308-3486 | 2007-12-03 |
| 1013199561 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 1680 Suburban Ave, Saint Paul, MN 55106-6632 | 2007-11-27 |
| 1093997546 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 1340 Duckwood Dr, Eagan, MN 55123-2324 | 2007-11-27 |
| 1275715732 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 5001 Winnetka Ave N, New Hope, MN 55428-4230 | 2007-11-27 |
| 1295917755 | Family & Cosmetic Gentle Dentistry, Ltd | Dentist | 5401 Chicago Ave, Minneapolis, MN 55417-2443 | 2007-11-27 |
| Street Address |
2147 NORTHDALE BLVD NW |
| City | COON RAPIDS |
| State | MN |
| Zip Code | 55433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003286808 | Modern Dental Professionals, Mn PC | Dentist | 2147 Northdale Blvd Nw, Nwood, Coon Rapids, MN 55433-3006 | 2015-10-06 |
| 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 | 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 |
|---|---|---|---|---|
| 1245857655 | Paul Yaeger | Dentist | 3570 River Rapids Dr Nw, Coon Rapids, MN 55448-4100 | 2020-07-01 |
| 1932767688 | Levi Bursch | Dentist | 3570 River Rapids Dr Nw # 110, Coon Rapids, MN 55448-4100 | 2019-05-29 |
| 1154828242 | Karin Lea Englund | Dentist | 9145 Springbrook Dr Nw Ste 100, Coon Rapids, MN 55433 | 2018-04-06 |
| 1316450091 | Tran Dental LLC | Dentist | 3570 River Rapids Dr Nw Ste 110, Coon Rapids, MN 55448-4100 | 2017-11-16 |
| 1003286808 | Modern Dental Professionals, Mn PC | Dentist | 2147 Northdale Blvd Nw, Nwood, Coon Rapids, MN 55433-3006 | 2015-10-06 |
| 1609279140 | Marissa Kaplan | Dentist | 13040 Riverdale Dr Nw Ste 600, Coon Rapids, MN 55448-8419 | 2014-09-29 |
| 1467899708 | Sanket R Nagarkar | Dentist | 3161 Northdale Blvd, Coon Rapids, MN 55433 | 2013-05-28 |
| 1619287562 | Northdale Dentist Pa | Dentist | 2147, Northdale Blvd Nw., Coon Rapids, MN 55433 | 2010-10-13 |
| 1881914182 | Katie Daniels | Dentist | 8960 Springbrook Dr Nw Ste 150, Coon Rapids, MN 55433-5809 | 2010-06-09 |
| 1407085814 | Gina Lorraine Andersland | Dentist | 2519 Coon Rapids Blvd Nw, Coon Rapids, MN 55433-3952 | 2009-07-07 |
| Find all providers in COON RAPIDS | ||||
| City | COON RAPIDS |
| Zip Code | 55433 |
Please comment or provide details below to improve the information on FAMILY & COSMETIC GENTLE DENTISTRY, LTD.
| 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.