SUNNY MOON


Address: 10584 France Ave S, Bloomington, MN 55431-3538
Phone: 9526666000

SUNNY MOON (NPI# 1487154092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 125J00000X Dental Therapist DT98 MN Dental Providers

Office Location

Street Address 10584 FRANCE AVE S
City BLOOMINGTON
State MN
Zip Code 55431-3538

Providers in the same location

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

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 125J00000X
Grouping Dental Providers
Classification Dental Therapist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1982148227 Katie Olson Dental Therapist 8600 Nicollet Ave S, Bloomington, MN 55420 2016-12-06

Providers in the same taxonomy and state

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
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Competitor

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City BLOOMINGTON
Zip Code 55431

Improve Information

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Dataset Information

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.

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