MARK T. SHERMAN DDS PA (NPI# 1770195158) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770195158 |
Entity Type | Organization |
Organization Name | MARK T. SHERMAN DDS PA |
Practice Address |
31011 Rasmussen Rd Pequot Lakes MN 56472-1227 |
Mailing Address |
Po Box 128 Pequot Lakes MN 56472-0128 |
Practice Telephone | 2185688295 |
Mailing Telephone | 2185688295 |
Mailing Fax Number | 2185684702 |
Enumeration Date | 2020-08-18 |
Last Update Date | 2020-08-18 |
Authorized Official Name | MARK T SHERMAN (OWNER) |
Authorized Official Telephone | 2185688295 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | BOARD LICENSE | D11015 | 01 |
Other Name | Type Code |
---|---|
Pequot Lakes Dental Center | Former Legal Business Name - Organization |
Street Address |
31011 RASMUSSEN RD |
City | PEQUOT LAKES |
State | MN |
Zip Code | 56472-1227 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1659837698 | Bpoint Pharmacy Services Ltd | Pharmacy | 30833 North Star Dr, Suite 2, Breezy Point, MN 56472 | 2019-02-14 |
1477930006 | Senior Class Care of Pequot Lakes, Inc. | Assisted Living Facility | 8898 Schaller Road, Pequot Lakes, MN 56472 | 2015-05-04 |
1831440312 | Jeevan Singh Dhouni | Pharmacist | 30103 Osceola Circle, Breezy Point, MN 56472 | 2012-09-25 |
1396918884 | John Kloster | Optometrist | 4461 Main St, Pequot Lakes, MN 56472 | 2008-04-07 |
1326222811 | Senior Class Home Health Care LLC | Home Health | 30849 1st Street, Pequot Lakes, MN 56472 | 2007-12-20 |
1598979940 | Loy Pfeiffer Inc | Pharmacy | 30984 Government Drive, Pequot Lakes, MN 56472 | 2007-05-09 |
1972656411 | Access Home Care, LLC | Home Health | 30392 Suffolk Circle, Pequot Lakes, MN 56472 | 2007-01-19 |
1427134428 | Joyce E. Neuman & Dean S. Brandt Ptrs. | Durable Medical Equipment & Medical Supplies | 4450 Main St, Pequot Lakes, MN 56472 | 2006-10-31 |
1326133786 | Ryan Dennis Buell | Chiropractor | 31095 Bergquist Drive, Pequot Lakes, MN 56472-0008 | 2006-10-03 |
1376602656 | Pequot Lakes Chiropractic and Sports Injury Center P.a | Chiropractor | 31095 Bergquist Drive, Pequot Lakes, MN 56472-0008 | 2006-12-06 |
Find all providers in zip 56472 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033710025 | Theresa M. Snell | Clinic/Center | 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 | 2020-11-05 |
1376143248 | James M. Williams, D.d.s., P.a. | Clinic/Center | 620 Union St S, Mora, MN 55051-1818 | 2020-10-29 |
1235746058 | Asp Dental, PC | Clinic/Center | 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 | 2020-09-25 |
1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
1518574532 | Stillwater Family Dental | Clinic/Center | 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 | 2020-09-24 |
1093321531 | Barnett Dental Inc | Clinic/Center | 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 | 2020-09-21 |
1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
1689286015 | Lifelong Dental Care | Clinic/Center | 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 | 2020-08-18 |
1528678497 | Custom Smiles Dentistry, Pllc | Clinic/Center | 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 | 2020-08-05 |
1720698152 | Curtis & Larson Dental Office, Pa | Clinic/Center | 820 3rd Ave Sw, Sleepy Eye, MN 56085-1816 | 2020-07-31 |
Find all providers with the same taxonomy |
City | PEQUOT LAKES |
Zip Code | 56472 |
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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.