OAK PARK DENTAL CLINIC (NPI# 1508036070) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508036070 |
| Entity Type | Organization |
| Organization Name | OAK PARK DENTAL CLINIC |
| Practice Address |
505 Johnson Ave Se Pine City MN 55063-2108 |
| Practice Telephone | 3206292282 |
| Practice Fax Number | 3206293357 |
| Mailing Telephone | 3206292282 |
| Mailing Fax Number | 3206293357 |
| Enumeration Date | 2008-03-11 |
| Last Update Date | 2008-03-12 |
| Authorized Official Name | DR. JON E CRUZ (DENTIST/OWNER) |
| Authorized Official Telephone | 3206292282 |
| 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 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285760751 | Oak Park Dental Clinic | Clinic/Center | 24164 Highway 35-70, Siren, WI 54872 | 2007-02-26 |
| Street Address |
505 JOHNSON AVE SE |
| City | PINE CITY |
| State | MN |
| Zip Code | 55063-2108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720063589 | Jon E Cruz | Dentist | 505 Johnson Ave Se, Pine City, MN 55063-2108 | 2005-12-14 |
| 1609298355 | 4th Avenue Dental, Pa, Dba Oak Park Dental | Dentist | 505 Johnson Ave Se, Pine City, MN 55063-2108 | 2014-01-15 |
| 1568433563 | Carrie Carlson | Dentist | 505 Johnson Ave Se, Pine City, MN 55063-2108 | 2006-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861025595 | B&b Guardian Angels Home Care Services, Inc | Home Health | 27680 Beroun Crossing Road, Pine City, MN 55063 | 2020-02-21 |
| 1346684289 | Power Chairs and Scooter Store Medical Supply LLC | Durable Medical Equipment & Medical Supplies | 540 Main St S, Pine City, MN 55063 | 2013-04-22 |
| 1225387327 | Avalon Meridian Behavioral Health | Health Maintenance Organization | 645 3rd Avenue Sw, Pine City, MN 55063 | 2012-09-05 |
| 1629226949 | Community Supports Programming Services LLC | Home Health | 500 3rd Ave Se, Suite 2, Pine City, MN 55063 | 2008-08-28 |
| 1033233788 | Meadow Creek LLC | Substance Abuse Rehabilitation Facility | 17305 Meadow Creek Lane, Pine City, MN 55063 | 2007-03-19 |
| 1477647006 | Rachel E Waxberg | Chiropractor | 805 Main Street South, Pine City, MN 55063 | 2006-10-03 |
| 1306947494 | Joseph Norbert Nilsson | Chiropractor | 253 5th St Se, Pine City, MN 55063 | 2006-09-25 |
| 1851324313 | Pine Eye Associates, Pa | Optometrist | 110 Evergreen Square, Pine City, MN 55063 | 2006-07-08 |
| 1053372656 | Kristie Ann Roberts | Dentist | 1105 Hillside Ave Sw, Pine City, MN 55063 | 2006-03-31 |
| 1114495827 | Kelly Ann Buchta | Social Worker | 220 Railroad St Se, Pine City, MN 55063 | 2018-11-12 |
| Find all providers in zip 55063 | ||||
| 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 |
|---|---|---|---|---|
| 1376618405 | Dylan J Ascheman | Dentist | 705 4th Ave Sw, Pine City, MN 55063-1604 | 2006-11-22 |
| 1053372656 | Kristie Ann Roberts | Dentist | 1105 Hillside Ave Sw, Pine City, MN 55063 | 2006-03-31 |
| 1720063589 | Jon E Cruz | Dentist | 505 Johnson Ave Se, Pine City, MN 55063-2108 | 2005-12-14 |
| 1609298355 | 4th Avenue Dental, Pa, Dba Oak Park Dental | Dentist | 505 Johnson Ave Se, Pine City, MN 55063-2108 | 2014-01-15 |
| 1568433563 | Carrie Carlson | Dentist | 505 Johnson Ave Se, Pine City, MN 55063-2108 | 2006-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962001149 | Kalyan Chakravarthy Kondreddi | Dentist | 327 Western Ave Ste A, Fergus Falls, MN 56537-2403 | 2020-10-20 |
| 1821696022 | Wyoming Family Dental | Dentist | 5378 East Viking Blvd., Wyoming, MN 55092 | 2020-10-12 |
| 1770190951 | Bluff Creek Dental Pllc | Dentist | 600 Market St Ste 130, Chanhassen, MN 55317-4570 | 2020-09-30 |
| 1205443850 | Birchwood Dental, LLC | Dentist | 3356 Sherman Crt Ste 101, Eagan, MN 55121 | 2020-09-28 |
| 1073128153 | Michael W Flinn Dds, Pa | Dentist | 200 Firewood Drive, Redwood, MN 56283 | 2020-09-15 |
| 1770196891 | Thomas J Hoeffel Dds Pa | Dentist | 2819 Hamline Ave N Ste 104, Roseville, MN 55113-7718 | 2020-08-28 |
| 1073123030 | True North Community Dental Clinic, LLC | Dentist | 415 East First Avenue, Shakopee, MN 55379 | 2020-08-05 |
| 1679182687 | Downtown Dental Center Pllc | Dentist | 825 Nicollet Mall Ste 1427, Minneapolis, MN 55402-2703 | 2020-07-26 |
| 1205444791 | Patrick Reilly Steck | Dentist | 4948 S 34th Ave, Minneapolis, MN 55417 | 2020-07-21 |
| 1386252344 | Kacie Crowell Green | Dentist | 8900 Walnut St # 459, Rockford, MN 55373-5135 | 2020-07-16 |
| Find all providers with the same taxonomy | ||||
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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.