LEWISTON DENTAL CARE (NPI# 1801443049) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1801443049 |
Entity Type | Organization |
Organization Name | LEWISTON DENTAL CARE |
Practice Address |
560 Debra Dr Lewiston MN 55952 |
Mailing Address |
560 Debra Dr Po Box 697 Lewiston MN 55952 |
Practice Telephone | 5075231071 |
Practice Fax Number | 5075231078 |
Mailing Telephone | 5075231071 |
Mailing Fax Number | 5075231078 |
Enumeration Date | 2019-08-22 |
Last Update Date | 2019-08-22 |
Authorized Official Name | DR. BRADLEY JOHN BULLARD (DENTIST/OWNER) |
Authorized Official Telephone | 5075231071 |
Authorized Official Credential | DDS |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
Street Address |
560 DEBRA DR |
City | LEWISTON |
State | MN |
Zip Code | 55952 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629169909 | Michael Thomas Flynn | Dentist | 560 Debra Dr, Lewiston, MN 55952-2104 | 2006-09-28 |
1073796744 | Modern Dental Professionals, Mn PC | Dentist | 560 Debra Dr, Lewiston, MN 55952-2104 | 2007-12-17 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386918746 | Carrie Lee Elliott-plank | Registered Nurse | 21839 Almon Dr., Lewiston, MN 55952 | 2012-03-02 |
1154411205 | City of Lewiston | Ambulance | 75 Rice Street, Lewiston, MN 55952 | 2006-10-12 |
1437292125 | Winona County Ind School Dist 857 | Local Education Agency (LEA) | 105 S Fremont, Lewiston, MN 55952-0741 | 2007-02-14 |
1336449172 | Mickel Frisch | Contractor | 395 Williams St, Lewiston, MN 55952-1109 | 2010-10-27 |
1265436653 | Deloughery Home Limited Partnership | Skilled Nursing Facility | 505 E Main St, Lewiston, MN 55952-1204 | 2005-06-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780285247 | Genuine Home Care LLC | In Home Supportive Care | 190 Bates St Ste 2-3, Lewiston, ME 04240-7329 | 2020-11-02 |
1609476852 | Allied Community Services LLC | Community/Behavioral Health | 476 Sabattus St, Lewiston, ME 04240-4111 | 2020-10-27 |
1124627765 | Peace Care Services LLC | Community/Behavioral Health | 145 Lisbon St Ste 508, Lewiston, ME 04240-7241 | 2020-10-24 |
1285231753 | Left Bank Recovery Services | Clinic/Center | 37 Park St Ste 303, Lewiston, ME 04240-7195 | 2020-10-07 |
1316544919 | Micro Direct, Inc. | Durable Medical Equipment & Medical Supplies | 803 Webster St, Lewiston, ME 04240-1600 | 2020-10-06 |
1013514926 | Strive Home Care LLC | Home Health | 145 Lisbon St Ste 402, Lewiston, ME 04240-7235 | 2020-10-04 |
1962009993 | April Jodie Bolduc | Physical Therapist | 61 Allen Ave, Lewiston, ME 04240-4826 | 2020-10-02 |
1629685235 | Mark Mitchell Roubidoux II | Nurse Practitioner | 201 18th Ave, Lewiston, ID 83501-2768 | 2020-09-28 |
1164039988 | Seth Thomas Six | Nurse Practitioner | 803 Mill Rd, Lewiston, ID 83501-0745 | 2020-09-25 |
1538774013 | Taylor Eells | Occupational Therapist | 984 Sabattus St Unit 4, Lewiston, ME 04240-3363 | 2020-09-11 |
Find all providers in LEWISTON |
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 |
---|---|---|---|---|
1104483122 | Meghan Cyrena Bristlin | Dentist | 3326 4th St Ste 3, Lewiston, ID 83501-4455 | 2019-05-24 |
1104320720 | Jronald Michael Ayzin | Dentist | 2360 Thain Grade, Lewiston, ID 83501-4115 | 2018-03-19 |
1225222920 | James P. Herbert, D.m.d., P.a. | Dentist | 22 Strawberry Ave, Lewiston, ME 04240-5961 | 2007-09-05 |
1225257041 | Gregory John Bengtson | Dentist | 602 11th Ave, Lewiston, ID 83501-2837 | 2007-04-24 |
1578693495 | David C Dortch | Dentist | 3318 4th St, Lewiston, ID 83501-4405 | 2007-03-07 |
1164562708 | Daniel Joseph Bizier | Dentist | 210 Sabattus St, Lewiston, ME 04240-6347 | 2007-02-06 |
1174670848 | William Joseph Perez | Dentist | 1606 17th St, Lewiston, ID 83501-4031 | 2007-01-04 |
1861550998 | Pedro E Ruiz | Dentist | 2360 Thain Grd, Aspen Dental, Lewiston, ID 83501 | 2006-12-04 |
1922173582 | Mark Wilson Sheppard | Dentist | 77 Southway Ave Ste A, Lewiston, ID 83501-2203 | 2006-11-21 |
1629169909 | Michael Thomas Flynn | Dentist | 560 Debra Dr, Lewiston, MN 55952-2104 | 2006-09-28 |
Find all providers in LEWISTON |
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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.