LUNA LAND DENTAL, CORP. (NPI# 1871064105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871064105 |
| Entity Type | Organization |
| Organization Name | LUNA LAND DENTAL, CORP. |
| Practice Address |
1215 Rice St Saint Paul MN 55117-4538 |
| Mailing Address |
393 Dunlap St N Ste 308 Saint Paul MN 55104-4223 |
| Practice Telephone | 6512929331 |
| Mailing Telephone | 6517887045 |
| Enumeration Date | 2018-12-16 |
| Last Update Date | 2018-12-16 |
| Authorized Official Name | DR. DAVID PARK (OWNER/CEO) |
| Authorized Official Telephone | 4437590910 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Clear Lakes Dental | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689181489 | Luna Land Dental, Corp. | Clinic/Center | 555 Wabasha St N Ste 250, Saint Paul, MN 55102-1673 | 2018-01-03 |
| 1821513375 | Luna Land Dental, Corp. | Clinic/Center | 393 Dunlap St N Ste 308, Saint Paul, MN 55104-4223 | 2017-08-06 |
| Street Address |
1215 RICE ST |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55117-4538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376549352 | Gregory Michael Sheehan | Dentist | 1215 Rice St, Saint Paul, MN 55117-4538 | 2005-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306309992 | Katrina Gregor | Social Worker | Po Box 17370 Lot 537, St. Paul, MN 55117 | 2019-04-10 |
| 1083160352 | Miracle Home Health Care, Inc. | Home Health | 55 Lyton Place, Saint Paul, MN 55117 | 2016-08-28 |
| 1871958827 | Roxanne Marie Cruciani | Physical Therapy Assistant | 41 East County Road C, #211, Little Canada, MN 55117 | 2015-12-17 |
| 1386064111 | Laura Giegler | Family Medicine | 1983 Sloan Pl Ste 1, Saint Paul, MN 55117 | 2014-04-19 |
| 1235564352 | Jennifer Ann Bertolatus | Counselor | 1585 Rice Street, St. Paul, MN 55117 | 2013-09-09 |
| 1851670400 | Healthy Community Services Agency, Inc | Home Health | 1096 Rice St., St. Paul, MN 55117 | 2011-08-15 |
| 1609184639 | Ondrea Perlman | Advanced Practice Midwife | 91 Viking Drive West, Little Canada, MN 55117 | 2010-09-24 |
| 1710126107 | Have A Heart Home Health Group, LLC | Home Health | 1973 Sloan Place, Suite 70, Maplewood, MN 55117 | 2009-02-09 |
| 1508052424 | Integratiavecare Vadnais Heights LLC | Pharmacy | 5 East County Road B, Suite #2, Little Canada, MN 55117 | 2007-09-25 |
| 1174728257 | Step Therapies, Inc. | Specialist | 75 W Viking Drive, Suite 101, Little Canada, MN 55117 | 2007-06-18 |
| Find all providers in zip 55117 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144860685 | Mn Community Care- Downtown Clinic Dental | Clinic/Center | 424 Dorothy Day Place, Saint Paul, MN 55102-1025 | 2020-01-13 |
| 1184980112 | St. Anthony Park Dental Arts, P.a. | Clinic/Center | 2282 Como Ave, Saint Paul, MN 55108-1722 | 2012-04-04 |
| 1417007436 | West Side Community Health Services, Inc. | Clinic/Center | 478 Robert St S, Saint Paul, MN 55107-2236 | 2007-01-11 |
| 1407914674 | Amherst H. Wilder Foundation | Clinic/Center | 516 Humboldt Ave, Saint Paul, MN 55107 | 2006-12-04 |
| 1154933661 | Grand Avenue Dental, LLC | Clinic/Center | 960 Grand Ave, Saint Paul, MN 55105-3014 | 2020-08-18 |
| 1043870645 | St Paul Oral Surgery and Dental Implants LLC | Clinic/Center | 2550 University Ave W Ste 115n, Saint Paul, MN 55114-1097 | 2019-06-17 |
| 1427519529 | Bright Smiles Dental Program | Clinic/Center | 153 Cesar Chavez St, Saint Paul, MN 55107-2226 | 2019-03-29 |
| 1033675871 | N&m Dds | Clinic/Center | 483 Brimhall St, Saint Paul, MN 55116-1508 | 2019-02-18 |
| 1689181489 | Luna Land Dental, Corp. | Clinic/Center | 555 Wabasha St N Ste 250, Saint Paul, MN 55102-1673 | 2018-01-03 |
| 1144735234 | Lisa Mcgann, Dds, Pa | Clinic/Center | 757 Cleveland Ave S Ste 2, Saint Paul, MN 55116-1301 | 2017-12-11 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55117 |
Please comment or provide details below to improve the information on LUNA LAND DENTAL, CORP..
| 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.