DENTAL SPECIALISTS OF MINNESOTA, PLLC (NPI# 1780750539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780750539 |
| Entity Type | Organization |
| Organization Name | DENTAL SPECIALISTS OF MINNESOTA, PLLC |
| Other Organization Name | THE DENTAL SPECIALISTS |
| Practice Address |
1835 County Road C-west Suite 200 Roseville MN 55113-1343 |
| Mailing Address |
2200 County Road C W Suite 2210 Roseville MN 55113-2550 |
| Practice Telephone | 6517960193 |
| Mailing Telephone | 6516330500 |
| Mailing Fax Number | 6516366350 |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | DR. ALAN LAW (PRESIDENT) |
| Authorized Official Telephone | 6516330500 |
| Authorized Official Credential | D.D.S., PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers | ||
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| The Dental Specialists | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396095048 | Dental Specialists of Minnesota, Pllc | Dentist | 3360 Northdale Blvd., Coon Rapids, MN 55448-1825 | 2012-09-10 |
| 1922308113 | Dental Specialists of Minnesota, Pllc | Dentist | 12904 Central Ave. Ne, Blaine, MN 55434 | 2010-10-22 |
| 1508932344 | Dental Specialists of Minnesota, Pllc | Dentist | 40 W Nicollet Blvd, Burnsville, MN 55337-4524 | 2006-11-24 |
| 1003431263 | Dental Specialists of Minnesota, Pllc | Dentist | 14525 Highway 7 Ste 125, Minnetonka, MN 55345-3738 | 2020-06-13 |
| 1760013015 | Dental Specialists of Minnesota, Pllc | Dentist | 15015 Cimarron Ave, Rosemount, MN 55068-2771 | 2020-01-27 |
| 1851772362 | Dental Specialists of Minnesota, Pllc | Dentist | 2200 County Road C W, Suite 2210, Roseville, MN 55113-2550 | 2015-06-11 |
| 1619382876 | Dental Specialists of Minnesota, Pllc | Dentist | 12180 Business Park Blvd N, Champlin, MN 55316-4525 | 2014-06-26 |
| 1558776716 | Dental Specialists of Minnesota, Pllc | Dentist | 1150 Hazeltine Blvd, Chaska, MN 55318-1004 | 2014-06-26 |
| 1710317417 | Dental Specialists of Minnesota, Pllc | Dentist | 11240 Stillwater Blvd N, Lake Elmo, MN 55042-9321 | 2013-11-15 |
| 1003245333 | Dental Specialists of Minnesota, Pllc | Dentist | 1109 Moore Lake Dr E, Fridley, MN 55432-5171 | 2013-11-07 |
| Street Address |
1835 COUNTY ROAD C-WEST SUITE 200 |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-1343 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144672874 | Andrey Antonenko | Dentist | 10 Sierra Gate Plz Ste 190, Roseville, CA 95678-6647 | 2016-07-06 |
| 1316221674 | Dwyer & Dow, A Dental Corp. | Dentist | 730 Sunrise Avenue #110, Roseville, CA 95661-4549 | 2011-10-05 |
| 1922296391 | Bruce M. Holt, D.d.s., Inc. | Dentist | 1421 Secret Ravine Pkwy., Suite 101, Roseville, CA 95661 | 2007-10-10 |
| 1740357706 | James Robert Dow | Dentist | 730 Sunrise Ave, Suite 110, Roseville, CA 95661-4549 | 2006-11-28 |
| 1275617367 | Thomas George Dwyer | Dentist | 730 Sunrise Avenue, #110, Roseville, CA 95661-4549 | 2006-10-25 |
| 1659936441 | Wdwrosevillepllc | Dentist | 21055 E 12 Mile Rd, Roseville, MI 48066-2205 | 2019-05-07 |
| 1962888354 | Pacharee Kulwattanaporn | Dentist | 18303 E 10 Mile Rd, Suite 150, Roseville, MI 48066-4988 | 2015-08-07 |
| 1851772362 | Dental Specialists of Minnesota, Pllc | Dentist | 2200 County Road C W, Suite 2210, Roseville, MN 55113-2550 | 2015-06-11 |
| 1891933875 | Edmond Kenneth Chow | Dentist | 2420 Professional Dr, Roseville, CA 95661-7773 | 2009-01-28 |
| 1194980284 | Kevin J. O'neill, D.d.s., M.s.d., Inc. | Dentist | 10 Sierra Gate Plz, Suite #190, Roseville, CA 95678-6645 | 2008-07-28 |
| Find all providers in ROSEVILLE | ||||
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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.