SUNNY MOON (NPI# 1487154092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487154092 |
Entity Type | Individual |
Full Name | SUNNY MOON |
Credential | DT |
Practice Address |
10584 France Ave S Bloomington MN 55431-3538 |
Mailing Address |
636 Broadway St Ne Minneapolis MN 55413-2164 |
Practice Telephone | 9526666000 |
Enumeration Date | 2018-02-20 |
Last Update Date | 2020-02-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 125J00000X | Dental Therapist | DT98 | MN | Dental Providers |
Street Address |
10584 FRANCE AVE S |
City | BLOOMINGTON |
State | MN |
Zip Code | 55431-3538 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992336291 | Brooke Marie Gall | Physician Assistant | 10584 France Ave S, Bloomington, MN 55431-3538 | 2020-01-27 |
1366006975 | Action for East African People Afeap | Pharmacy | 10584 France Ave S, Bloomington, MN 55431-3538 | 2019-04-29 |
1497218184 | Action Dental | Clinic/Center | 10584 France Ave S, Bloomington, MN 55431-3538 | 2019-04-09 |
1578028288 | Actioncare Community Clinic Inc | Clinic/Center | 10584 France Ave S, Bloomington, MN 55431-3538 | 2019-02-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578162509 | Mckenzie Mcadaragh | Nurse Practitioner | 10924 Girard Curve, Bloomington, MN 55431 | 2020-10-21 |
1760042253 | Adams Health Care Services, LLC | Registered Nurse | 10036 Washburn Ave S, Bloomington, MN 55431 | 2019-06-17 |
1851864755 | Hope Autism Center | Day Training, Developmentally Disabled Services | 9333 Penn Ave S, Bloomington, MN 55431 | 2019-01-03 |
1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
1497240469 | Mikayla Slegh | Behavior Technician | 8200 Humboldt Ave S Suite 100, Bloomington, MN 55431 | 2018-06-22 |
1073061552 | David Wells | Nurse Practitioner | 8100 Northland Dr., Bloomington, MN 55431 | 2016-09-14 |
1780033076 | Yasin Jama | Contractor | 9810 Drew Avenue South, Apartment 106, Bloomington, MN 55431 | 2016-06-07 |
1972961001 | Kadar Hadis | Social Worker | 8200 Humboldt Ave S Ste 217, Bloomington, MN 55431 | 2016-02-03 |
1063878908 | Amazing Transportation Services, LLC | Non-emergency Medical Transport (VAN) | 9031 Penn Ave South Suite 100, Bloomington, MN 55431 | 2016-01-07 |
1093170136 | Kelsey Margaret Perreault | Chiropractor | 8120 Penn Ave. S., Suite 525, Bloomington, MN 55431 | 2015-12-16 |
Find all providers in zip 55431 |
Taxonomy Code | 125J00000X |
Grouping | Dental Providers |
Classification | Dental Therapist |
A Dental Therapist is an individual who has completed an accredited or non-accredited dental therapy program and who has been authorized by the relevant state board or a tribal entity to provide services within the scope of their practice under the supervision of a dentist. Functions that may be delegated to the dental therapist vary based on the needs of the dentist, the educational preparation of the dental therapist and state dental practice acts and regulations. |
Notes: Source: Summarized from Minnesota Statute 150A.105. [7/1/2012: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982148227 | Katie Olson | Dental Therapist | 8600 Nicollet Ave S, Bloomington, MN 55420 | 2016-12-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1487264446 | Amber Nichelle Irby | Dental Therapist | 903 W Center St #130, Rochester, MN 55902 | 2020-08-05 |
1558835942 | Jennifer Iacobelli | Dental Therapist | 13899 Highway 13 South Frontage Road, Savage, MN 55378 | 2019-01-18 |
1992288781 | Katie Ask | Dental Therapist | 13889 Highway 13 S, Frontage Rd, Savage, MN 55378 | 2018-09-08 |
1326548454 | Julie Bonham | Dental Therapist | 803 3rd St. Se, Suite 330, Little Falls, MN 56345 | 2018-02-15 |
1376077974 | Saritha Gajawada | Dental Therapist | 15354 Plumstone Dr, Eden Prairie, MN 55347-2061 | 2017-04-20 |
1649644063 | Brittany Gronland | Dental Therapist | 25730 Smithtown Rd, Excelsior, MN 55331-8592 | 2015-11-23 |
1124405857 | Jenna Susanne Marquardt | Dental Therapist | 209 South 1st Street, Montevideo, MN 56265 | 2015-05-01 |
1558751495 | Weston Mark Schmidt | Dental Therapist | 411 East Howard St., Jacobson Family Dentistry PC, Hibbing, MN 55746 | 2015-01-30 |
1003230137 | Janelle Jehn | Dental Therapist | 4342 4th Ave S, Minneapolis, MN 55409-2155 | 2014-02-10 |
1346506011 | Lindsey Lee Tischer | Dental Therapist | 205 Pleasant Ave, Park Rapids, MN 56470-1432 | 2012-04-07 |
Find all providers with the same taxonomy |
City | BLOOMINGTON |
Zip Code | 55431 |
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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.