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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
8638530 | MN | Dental Providers |
Street Address |
4201 DEAN LAKES BLVD SUITE 110 |
City | SHAKOPEE |
State | MN |
Zip Code | 55379-2829 |
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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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 |
Find all providers in zip 55379 |
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 |
---|---|---|---|---|
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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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.