SHAKOPEE DENTAL P.L.L.C.


Address: 4201 Dean Lakes Blvd, Suite 110, Shakopee, MN 55379-2829
Phone: 9522331020

SHAKOPEE DENTAL P.L.L.C. (NPI# 1730308792) 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) 1730308792
Entity Type Organization
Organization Name SHAKOPEE DENTAL P.L.L.C.
Practice Address 4201 Dean Lakes Blvd
Suite 110
Shakopee
MN 55379-2829
Practice Telephone 9522331020
Practice Fax Number 9522331309
Mailing Telephone 9522331020
Mailing Fax Number 9522331309
Enumeration Date 2007-04-25
Last Update Date 2020-08-22
Authorized Official Name LUIS E. SILVA (PRESIDENT)
Authorized Official Telephone 9522331020
Authorized Official Credential D.D.S.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1223G0001X Dentist
Specialization: General Practice
8638530 MN Dental Providers

Office Location

Street Address 4201 DEAN LAKES BLVD
SUITE 110
City SHAKOPEE
State MN
Zip Code 55379-2829

Providers in the same location

NPI Name Taxonomy Address Enumeration
1740382274 Edina Eye Physicians and Surgeons Pa Optometrist 4201 Dean Lakes Blvd, Suite 100, Shakopee, MN 55379-2829 2006-09-04
1730787375 Mary Kay Yozamp Behavior Technician 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2020-10-15
1336747468 Shawna Johnson Technician, Other 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2020-10-12
1265039531 Robb Luther Hawkinson Behavior Technician 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2020-10-08
1104430255 Harley Jean Brake Walker Behavior Technician 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2020-09-05
1639783228 Grace Lee Technician, Other 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2020-09-01
1932710514 Taylor Donart Technician, Other 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2020-08-16
1629696752 Disha Japa Technician, Other 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2020-07-06
1730439688 Tamara K Baldwin Physician Assistant 4201 Dean Lakes Blvd, Shakopee, MN 55379-2829 2012-09-18
1174758908 Liza Antoinette Jain Phu Family Medicine 4201 Dean Lakes Blvd, #120, Shakopee, MN 55379-2829 2009-05-22
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1073123030 True North Community Dental Clinic, LLC Dentist 415 East First Avenue, Shakopee, MN 55379 2020-08-05
1154988236 Benedictine Living Community of Shakopee LLC Assisted Living Facility 1705 Windermere Way, Shakopee, MN 55379 2019-05-23
1346741394 Expressions In Motion LLC Speech-Language Pathologist 1221 East 4th Ave., Shakopee, MN 55379 2018-02-26
1124529334 A.m Dental Professionals P.a Clinic/Center 1036 1st Ave E, Shakopee, MN 55379 2018-02-22
1538522024 Jesse Sylvester Chiropractor 1275 Ramsey Street South, #600, Shakopee, MN 55379 2016-04-01
1376903963 Dakota Best Transportation LLC Non-emergency Medical Transport (VAN) 449 Dakota Street Apt 2, Shakopee, MN 55379 2016-02-25
1568856631 Tatyana Mishkin Gleyzer Nurse Practitioner 1010 West Sixth Avenue, Shakopee, MN 55379 2015-03-26
1245634039 Kalli Ledel Pharmacist 1198 Vierling Dr, Cub Pharmacy, Shakopee, MN 55379 2014-10-22
1487992913 Jennifer Elizabeth Boyd Nurse Practitioner Pediatrics 1415 St Francis Ave, Park Nicollet Clinic-shakopee, Shakopee, MN 55379 2013-01-17
1013253798 Acts Therapy LLC Counselor 8170 Old Carriage Court North, 215, Shakopee, MN 55379 2012-12-27
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Taxonomy Information

Taxonomy Code 1223G0001X
Grouping Dental Providers
Classification Dentist
Specialization General Practice

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1073123030 True North Community Dental Clinic, LLC Dentist 415 East First Avenue, Shakopee, MN 55379 2020-08-05
1891140075 Merissa Richter Dentist 4180 Dean Lakes Blvd, Shakopee, MN 55379-2851 2016-04-26
1619103827 Katie Ferraz-souza Dentist 250 Fuller St. S, Suite 250, Shakopee, MN 55379 2009-06-02
1689866600 Lindsey Vossen Dentist 1759 17th Ave E, Shakopee, MN 55379-3372 2007-08-14
1346462355 Crossings Dental Care Dentist 8170 Old Carriage Ct Ste 150, Shakopee, MN 55379-3163 2007-05-02
1225150881 Cities Dentistry, Pa Dentist 235 1st Ave E, Shakopee, MN 55379-1440 2007-04-04
1497843189 John Eugene Elvecrog Dentist 8170 Old Carriage Ct, Suite 150, Shakopee, MN 55379-3163 2006-10-10
1780787473 James J O'brien Dentist 1221 4th Ave E, Sutie 180, Shakopee, MN 55379-1681 2006-09-07
1225048663 Michael William England Dentist 8074 Old Carriage Ct, Shakopee, MN 55379-3156 2006-08-08
1659332252 Alan Charles Perry Dentist 415 1st Ave E, Shakopee, MN 55379-1439 2006-03-31
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Competitor

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City SHAKOPEE
Zip Code 55379

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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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