JOAN MAZA ATTRIDGE (NPI# 1902034382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902034382 |
| Entity Type | Individual |
| Full Name | JOAN MAZA ATTRIDGE |
| Credential | DDS |
| Practice Address |
425 7th St Nw Cass Lake MN 56633 |
| Mailing Address |
425 7th St Nw Cass Lake MN 56633-3360 |
| Practice Telephone | 2183353230 |
| Practice Fax Number | 2183553368 |
| Mailing Telephone | 2183553230 |
| Mailing Fax Number | 2183353368 |
| Enumeration Date | 2009-06-24 |
| Last Update Date | 2019-01-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 2901020044 | MI | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
S141 | MN | Dental Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 30481 | IA | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 201 Dental Science Bldg S, Iowa City, IA 522421001 | 3193357485 |
| Street Address |
425 7TH ST NW |
| City | CASS LAKE |
| State | MN |
| Zip Code | 56633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437133543 | Matei Teodorescu | Pediatrics | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2005-12-01 |
| 1063039642 | Barbara Lynn Naastad | Dental Hygienist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2020-06-30 |
| 1811527229 | Mai Lee Moua | Pharmacist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2020-01-24 |
| 1205369261 | Jessica Theisen | Pharmacist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2017-04-06 |
| 1578995957 | Rachel Washburn | Pharmacist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2013-08-07 |
| 1962742627 | Cassandra Jean Lappegaard | Optometrist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2013-02-18 |
| 1518201110 | Nokomis Paiz | Counselor | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2012-11-20 |
| 1639432396 | Alissa Massie | Physical Therapist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2012-06-19 |
| 1316252497 | Joshua Michael Nelson | Pharmacist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2010-08-12 |
| 1972817013 | Russell Devolder | Pharmacist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2010-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205485430 | Jessica Rose Malterud | Registered Nurse | 416-2nd Street Nw, Cass Lake, MN 56633 | 2019-09-10 |
| 1174079917 | Stacy Ann Cederstrom | Nurse Practitioner | 425 7th Street North East, Cass Lake, MN 56633 | 2016-08-31 |
| 1679933568 | Minnesota Chippewa Tribe Adult Day Services | Clinic/Center | 15546 State 371 Nw, Cass Lake, MN 56633 | 2016-03-04 |
| 1073979084 | Constance J Mangiamele | Registered Nurse | 190 Sailstar Dr. Nw, Cass Lake, MN 56633 | 2016-01-06 |
| 1194193086 | Whitney Dickson | Pharmacist | 425 7th Street Northwest, Cass Lake, MN 56633 | 2015-09-09 |
| 1245669332 | Marsha Ellen Kaehne | Nurse Practitioner | 119 Aspen Ave., Cass Lake, MN 56633 | 2013-11-08 |
| 1376985952 | Home Free Care, LLC | Home Health | 310 Norway Ave. Ne, Cass Lake, MN 56633 | 2013-07-23 |
| 1831468479 | Leech Lake Band of Ojibwe | Substance Abuse Rehabilitation Facility | 113 7th Stree Nw, Cass Lake, MN 56633 | 2011-12-28 |
| 1275823742 | Leech Lake Band of Ojibwe | Community/Behavioral Health | 16123 Grant Utley Ave Nw, Cass Lake, MN 56633 | 2011-04-18 |
| 1659679843 | Leech Lake Band of Ojibwe | Community/Behavioral Health | 115 6th Street Nw, Cass Lake, MN 56633 | 2011-03-11 |
| Find all providers in zip 56633 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770773855 | Laura Stewart | Dentist | 425 7th St Nw, Cass Lake, MN 56633-3360 | 2007-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477025906 | Riverdale Kidds Pediatric Dentistry, Pllc | Dentist | 3585 124th Ave Nw Ste 400, Coon Rapids, MN 55433-1008 | 2018-12-21 |
| 1467924290 | Camp Smile Pediatric Dentistry Excelsior Pllc | Dentist | 675 Water St Ste 2, Excelsior, MN 55331-3072 | 2018-12-18 |
| 1932671765 | Camp Smile Pediatric Dentistry Chaska | Dentist | 111 Hundertmark Rd Ste 304n, Chaska, MN 55318-1587 | 2018-12-18 |
| 1538678057 | Blaine Kidds Pediatric Dentistry Pllc | Dentist | 1351 113th Ave Ne, Blaine, MN 55434-3874 | 2017-09-27 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1710367925 | Lindsay Bedeaux | Dentist | 7373 France Ave S Ste 400, Edina, MN 55435-4549 | 2015-06-02 |
| 1609272822 | Rochester Pediatric Dentistry LLC | Dentist | 1705 S Boradway Ave Ste B, Rochester, MN 55904-7960 | 2014-11-16 |
| 1396186813 | Central Minnesota Pediatric Dentists Pa | Dentist | 507 N Nokomis St Ste C, Alexandria, MN 56308-2353 | 2013-07-12 |
| 1265873707 | Central Minnesota Pediatric Dentists Pa | Dentist | 570 Humboldt Dr Ste 102, Big Lake, MN 55309-4844 | 2013-07-12 |
| 1013264621 | Northland Dental Partners | Dentist | 3507 Round Lake Blvd. Suite 900, Anoka, MN 55303 | 2012-08-14 |
| Find all providers with the same taxonomy | ||||
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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.