MS. ERIKA ENRIQUEZ HAYCRAFT (NPI# 1710413752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710413752 |
| Entity Type | Individual |
| Full Name | MS. ERIKA ENRIQUEZ HAYCRAFT |
| Credential | M.D.T. |
| Practice Address |
1670 Beam Ave Ste 204 Maplewood MN 55109-1227 |
| Practice Telephone | 6519258400 |
| Mailing Telephone | 6519258400 |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 125J00000X | Dental Therapist | DT86 | MN | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 20959 Juno Ave N, Forest Lake, MN 550258921 | 6128757650 |
| Street Address |
1670 BEAM AVE STE 204 |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-1227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588894067 | Nicholas M Weinand | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2009-07-20 |
| 1033721139 | Xue Wang | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2020-08-19 |
| 1770061145 | Pao Chua Vang | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2018-07-29 |
| 1902390917 | Andrew Crist | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109 | 2018-06-22 |
| 1699266130 | Leah Svingen Mccomas | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2018-05-21 |
| 1104316801 | Chia Wam Moua | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2018-05-17 |
| 1821538265 | Michael Henderson | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2017-03-05 |
| 1336596527 | Pa Kou Yang | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2016-05-18 |
| 1639579329 | Chase Seubert | Dentist | 1670 Beam Ave Ste 204, Maplewood, MN 55109-1227 | 2014-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1487154092 | Sunny Moon | Dental Therapist | 10584 France Ave S, Bloomington, MN 55431-3538 | 2018-02-20 |
| 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 |
| 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.