MRS. CHRISTINA MARIE HUBRED


Address: Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744
Phone: 2183263437

MRS. CHRISTINA MARIE HUBRED (NPI# 1578117438) 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) 1578117438
Entity Type Individual
Full Name MRS. CHRISTINA MARIE HUBRED
Other Name CHRISTINA MARIE JOHNSON
Credential A D.T., DH
Practice Address Miskovich Dental Clinic
1121 Se 4th Avenue
Grand Rapids
MN 55744
Practice Telephone 2183263437
Practice Fax Number 2183271211
Mailing Telephone 2183263437
Mailing Fax Number 2183271211
Enumeration Date 2019-07-30
Last Update Date 2019-07-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 125K00000X Advanced Practice Dental Therapist DT75 MN Dental Providers

Office Location

Street Address MISKOVICH DENTAL CLINIC
1121 SE 4TH AVENUE
City GRAND RAPIDS
State MN
Zip Code 55744

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1104244987 Linda Reinen-thompson Contractor 34307 Hwy. 38, Grand Rapids, MN 55744 2014-03-31
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Taxonomy Information

Taxonomy Code 125K00000X
Grouping Dental Providers
Classification Advanced Practice Dental Therapist

Taxonomy Definition

An Advanced Practice Dental Therapist is:
(1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or
(2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability for clinical judgment across the dental health care continuum.

The individual has been authorized by the relevant state board or a tribal entity to provide services under the remote supervision of a dentist. The functions of the advanced practice dental therapist vary based on the needs of the dentist, the educational preparation of the advanced practice dental therapist and state dental practice acts and regulations.
Notes: Source: Summarized from Minnesota Statute 150A.106. [7/1/2012: new]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1144733130 Lydia J Diekmann Advanced Practice Dental Therapist 2711 Broadway Ave Ste A00, Slayton, MN 56172-1313 2017-11-13
1073872503 Brieanne Kelsey Borntrager Advanced Practice Dental Therapist 13899 Hwy 13 S Frnt Rd, Savage, MN 55378-2135 2012-05-03
1023541695 Carley Banks Advanced Practice Dental Therapist 1575 20th St Nw, Faribault, MN 55021 2017-04-10
1033642947 Lauren Johnson Advanced Practice Dental Therapist 1575 20th St Nw, Suite 102, Faribault, MN 55021-2930 2017-04-07
1063953032 Ashley Hueman Advanced Practice Dental Therapist 973 Skyline Dr Sw, Rochester, MN 55902-1220 2017-03-10
1124483656 Tanu Dhoopar Advanced Practice Dental Therapist 3152 Minnehaha Ave, Minneapolis, MN 55406-1934 2015-12-29
1548631187 Kaitlin Siewert Advanced Practice Dental Therapist 520 Main Street, Hawley, MN 56549 2015-10-08

Competitor

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City GRAND RAPIDS
Zip Code 55744

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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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