ORTHODONTIC SPECIALISTS OF MINNESOTA, P.L.L.C. (NPI# 1902398944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902398944 |
| Entity Type | Organization |
| Organization Name | ORTHODONTIC SPECIALISTS OF MINNESOTA, P.L.L.C. |
| Other Organization Name | THE DENTAL SPECIALISTS- ORTHODONTICS |
| Practice Address |
12904 Central Ave Ne Blaine MN 55434 |
| Mailing Address |
2200 County Road C W Ste 2210 Roseville MN 55113-2551 |
| Practice Telephone | 7632016960 |
| Mailing Telephone | 6517462815 |
| Enumeration Date | 2018-06-05 |
| Last Update Date | 2020-10-28 |
| Authorized Official Name | JOHN GULON (PRESEIDENT) |
| Authorized Official Telephone | 6517462815 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers |
| Other Name | Type Code |
|---|---|
| The Dental Specialists- Orthodontics | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588156525 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 18315 Cascade Dr Ste 110, Eden Prairie, MN 55347 | 2018-06-05 |
| 1629560677 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 9325 Upland Ln N Ste 330, Maple Grove, MN 55369-4462 | 2018-06-05 |
| 1548818560 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 675 E Nicollet Blvd Ste 120, Burnsville, MN 55337-6748 | 2019-09-03 |
| 1295227247 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 8650 Hudson Blvd N Ste 105, Lake Elmo, MN 55042 | 2018-06-05 |
| 1245722297 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 40 W Nicollet Blvd, Burnsville, MN 55337-4524 | 2018-06-05 |
| 1699267633 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 1150 Hazeltine Blvd, Chaska, MN 55318 | 2018-06-05 |
| 1306338553 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 1109 Moore Lake Dr E, Fridley, MN 55432 | 2018-06-04 |
| 1053685586 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 2200 County Road C W, Suite 2210, Roseville, MN 55113 | 2012-03-01 |
| 1821362302 | Orthodontic Specialists of Minnesota, P.l.l.c. | Dentist | 6545 France Ave S, Suite 381, Edina, MN 55435 | 2012-03-01 |
| Street Address |
12904 CENTRAL AVE NE |
| City | BLAINE |
| State | MN |
| Zip Code | 55434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215003371 | Pdg,p.a. | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2006-11-28 |
| 1578089207 | Andrea Berge | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2017-08-15 |
| 1104273085 | Thien Quang Pham | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2016-05-19 |
| 1003263377 | Allison Marie Mcmillen | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2016-05-17 |
| 1013355593 | Jeffrey Mark Ruhlmann | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2013-06-06 |
| 1376980755 | Shawn Mccarthy | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2013-05-27 |
| 1477600807 | Peter Jon Thompson | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2007-01-05 |
| 1083777411 | Anissa Jane Kozlowski | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2006-12-18 |
| 1215090659 | Robb David Kozlowski | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2006-12-18 |
| 1043379514 | Stephen Michael Sawyer | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2006-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628591 | Rahul Farmah | Optometrist | 680 Hwy 10 Ne, Blaine, MN 55434 | 2020-08-08 |
| 1033770714 | Enduring Home Health Care Corp | Home Health | 10812 Fillmore Street, Blaine, MN 55434 | 2019-06-24 |
| 1932762408 | Vital Agency LLC | In Home Supportive Care | 12864 Fillmore Street Ne, Blaine, MN 55434 | 2019-04-19 |
| 1548751654 | Dustin Adam Kakach | Pharmacist | 600 County Hwy 10, Blaine, MN 55434 | 2018-05-24 |
| 1598253445 | Jacob James Apland | Behavioral Analyst | 12401 Oak Park Blvd Ne Apt 316, Blaine, MN 55434 | 2018-04-26 |
| 1962921924 | Mw Minnetonka Operating LLC | Assisted Living Facility | 1005 Paul Parkway Ne, Blaine, MN 55434 | 2017-09-11 |
| 1922526961 | Blaine Asc, LLC | Clinic/Center | 11225 Ulysses Street Northeast, Blaine, MN 55434 | 2017-08-30 |
| 1629591334 | Minnehaha Transportation Inc | Non-emergency Medical Transport (VAN) | 2507 Walnut St, Roseville, MN 55434 | 2017-07-25 |
| 1629590872 | Alexandra Staum Reif | Pediatrics | 11107 Ulysses Street Ne, Suite 100, Blaine, MN 55434 | 2017-07-10 |
| 1962939546 | Nicolette Gengel | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434 | 2017-05-15 |
| Find all providers in zip 55434 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467936377 | Hani Alsibai | Dentist | 11806 Aberdeen St Ne Ste 240, Blaine, MN 55449-5136 | 2018-09-18 |
| 1659447670 | Douglas T Jonak Dds Pa | Dentist | 800 Main St Ne, Blaine, MN 55434 | 2006-11-28 |
| 1568557650 | Irving Anders | Dentist | 341 C St, Blaine, WA 98230-4209 | 2006-10-04 |
| 1376980755 | Shawn Mccarthy | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2013-05-27 |
| 1801910377 | Orthodontic Care Group | Dentist | 11806 Aberdeen St Ne, Blaine, MN 55449-4736 | 2007-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871100974 | Candid Minnesota, Pllc | Dentist | 15 S 9th St Ste 97, Minneapolis, MN 55402-3105 | 2020-09-23 |
| 1518572916 | Smile Orthodontics Stillwater LLC | Dentist | 2008 Ford Pkwy, Saint Paul, MN 55116-1931 | 2020-09-11 |
| 1508476482 | Sensational Smiles | Dentist | 950 Nicollet Mall Ste 220, Minneapolis, MN 55403-2534 | 2020-08-05 |
| 1457969636 | Eden Prairie Orthodontic Assoc | Dentist | 8200 Commonwealth Dr # 100, Eden Prairie, MN 55344-5365 | 2020-07-14 |
| 1164040457 | Colby Orthodontics LLC | Dentist | 9th St. and Nicollet Ave. Suite 531, Minneapolis, MN 55402 | 2020-07-13 |
| 1619595220 | Tracy Miao Liang | Dentist | 515 Delaware St Se # 320, Minneapolis, MN 55455-0357 | 2020-07-09 |
| 1477170108 | Jesse N Veil Dds Ms Pa | Dentist | 250 Fuller St S Ste 100, Shakopee, MN 55379-1324 | 2020-06-29 |
| 1124663067 | Bruce William Anderson | Dentist | 2725 Fox Farm Rd, Worthington, MN 56187-3040 | 2019-11-14 |
| 1598300675 | Dentalign, Pa | Dentist | 11942 Business Park Blvd, Champlin, MN 55316 | 2019-11-12 |
| 1528622883 | Margaret Therese Anderson | Dentist | 2019 Jefferson Rd Ste C, Northfield, MN 55057-3258 | 2019-04-23 |
| 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.