MR. PETER J MISKOVICH (NPI# 1780759944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780759944 |
| Entity Type | Individual |
| Full Name | MR. PETER J MISKOVICH |
| Credential | DDS |
| Practice Address |
1121 Se 4th Avenue Grand Rapids MN 55744 |
| Practice Telephone | 2183263437 |
| Practice Fax Number | 2183271211 |
| Mailing Telephone | 2183263437 |
| Mailing Fax Number | 2183271211 |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D11951 | MN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | STATE LICENSE NUMBER | D11951 | 01 |
| UNITED CONCORDIA | 1670908 | 01 | |
| MN | BLUE CROSS AND SH OF MN | 275L7MI | 01 |
| Street Address |
1121 SE 4TH AVENUE |
| City | GRAND RAPIDS |
| State | MN |
| Zip Code | 55744 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609941863 | Mike N Miskovich | Dentist | 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2006-11-22 |
| 1255407060 | Miskovich Dental Clinic | Dentist | 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2006-11-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710587696 | Friesen & Friesen, Inc | Assisted Living Facility | 1971 Ne 1st Avenue, Grand Rapids, MN 55744 | 2020-10-29 |
| 1699392555 | Duane Stanley Helmer | Counselor | First Call for Help of Itasca County, 1707 Nw 4th Street Suite B, Grand Rapids, MN 55744 | 2020-06-26 |
| 1821631391 | Patrice Marie Curtiss | Technician | 23792 Winckler Road, Grand Rapids, MN 55744 | 2019-10-28 |
| 1578117438 | Christina Marie Hubred | Advanced Practice Dental Therapist | Miskovich Dental Clinic, 1121 Se 4th Avenue, Grand Rapids, MN 55744 | 2019-07-30 |
| 1780081877 | Fcsl Grand Rapids, LLC | Assisted Living Facility | 949 1/2 Sw 11th Street, Grand Rapids, MN 55744 | 2014-12-04 |
| 1912311333 | Doctor V LLC | Psychologist | 2002 Cromell Drive, Hope House of Itasca County, Laprairie, MN 55744 | 2014-06-13 |
| 1104244987 | Linda Reinen-thompson | Contractor | 34307 Hwy. 38, Grand Rapids, MN 55744 | 2014-03-31 |
| 1275883266 | Lana Rae Jacobson | Registered Nurse | 1401 Nw 9th Street, Grand Rapids, MN 55744 | 2012-09-17 |
| 1518252048 | David Allen Griggs | Pharmacist | 2140 S.pokegama Ave., T-0904, Target, Grand Rapids, MN 55744 | 2011-06-13 |
| 1447575063 | Kelly Ann Shermoen | Pharmacist | 18 Se 10th Street, Grand Rapids, MN 55744 | 2010-04-07 |
| Find all providers in zip 55744 | ||||
| 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 |
|---|---|---|---|---|
| 1265059570 | Samuel T. Bander, Dds, Plc | Dentist | 1151 E Paris Ave Se Ste 100, Grand Rapids, MI 49546-8369 | 2020-07-02 |
| 1295360428 | Dj Edgerle, Dds, PC | Dentist | 751 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546-2391 | 2020-03-09 |
| 1639638265 | Mark E Peterson, Dds | Dentist | 2440 Gaynor Ave Nw, Grand Rapids, MI 49544-1830 | 2019-03-13 |
| 1811463730 | Ryan C. Van Haren, Dds Pllc | Dentist | 2144 E Paris Ave Se Ste 110, Grand Rapids, MI 49546-6111 | 2018-10-18 |
| 1386138881 | Jayson Lynn Clore | Dentist | 334 68th St Sw, Grand Rapids, MI 49548-7179 | 2018-06-18 |
| 1154788230 | Kb Family Dentistry Plc | Dentist | 3167 Kalamazoo Ave Se # 1, Grand Rapids, MI 49508-1475 | 2016-01-21 |
| 1821471616 | Healthy Smile Plc | Dentist | 2021 44th St Sw, Grand Rapids, MI 49508 | 2015-06-30 |
| 1841694387 | Jerry B. Mulder Dds Plc | Dentist | 515 Michigan St Ne Ste 202, Grand Rapids, MI 49503-5721 | 2014-10-13 |
| 1609277854 | Alexis Neuman | Dentist | 3930 Burton St Se, Grand Rapids, MI 49546-5819 | 2014-09-08 |
| 1124439476 | Bryton Mansfield | Dentist | 1636 Leonard St Nw, Grand Rapids, MI 49504-3950 | 2014-05-08 |
| Find all providers in GRAND RAPIDS | ||||
| City | GRAND RAPIDS |
| Zip Code | 55744 |
Please comment or provide details below to improve the information on MR. PETER J MISKOVICH.
| 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.