DR. GOTTFRED P OLSEN (NPI# 1932107372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932107372 |
| Entity Type | Individual |
| Full Name | DR. GOTTFRED P OLSEN |
| Credential | DDS |
| Practice Address |
1645 N Town East Blvd Ste 532 Mesquite TX 75150-4158 |
| Practice Telephone | 9726815936 |
| Practice Fax Number | 2148239972 |
| Mailing Telephone | 9726815936 |
| Mailing Fax Number | 2148239972 |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2011-12-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
12609 | TX | Dental Providers |
| Street Address |
1645 N TOWN EAST BLVD STE 532 |
| City | MESQUITE |
| State | TX |
| Zip Code | 75150-4158 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427299783 | Paul Manaloto | Chiropractor | 1645 N Town East Blvd, Ste 146, Mesquite, TX 75150-4146 | 2009-03-17 |
| 1437309309 | January Banaag Jones | Physician Assistant | 1645 N Town East Blvd, Suite 174, Mesquite, TX 75150-4158 | 2008-09-26 |
| 1528188307 | Jeanne D Opheim | Physical Therapist | 1645 N Town East Blvd, Suite 503, Mesquite, TX 75150-4158 | 2007-03-29 |
| 1942330220 | Richard Eusanio, D.p.m.,p.c. | Podiatrist | 1645 N Town East Blvd, #502, Mesquite, TX 75150-4158 | 2007-03-06 |
| 1356411359 | Healthy Changes Inc | Dietitian, Registered | 1645 N Town East Blvd, Suite 503, Mesquite, TX 75150-4158 | 2006-11-08 |
| 1417975723 | Mallapur S Rao | General Practice | 1645 N Town East Blvd, Suite 174, Mesquite, TX 75150-4158 | 2006-07-17 |
| 1164448304 | Rmbo Enterprises Ltd | Durable Medical Equipment & Medical Supplies | 1645 N Town East Blvd, Ste. 503, Mesquite, TX 75150-4158 | 2006-07-14 |
| 1790713535 | Kashmir Kaur | Nurse Practitioner | 1645 N Town East Blvd, Suite 503, Mesquite, TX 75150-4158 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124630991 | Affordable Home Health Care | Home Health | 3637 E. Us. Highway 80, Mesquite, TX 75150 | 2020-08-21 |
| 1245840933 | Shanikqu Lashun George | Specialist | 1515 N. Towneast Blvd., Suite 19, Mesquite, TX 75150 | 2020-08-06 |
| 1578109542 | Phyllis Renee Cephas | Counselor | 2200 N. Belt Line Road, #728, Mesquite, TX 75150 | 2019-11-25 |
| 1033766068 | Darryl E Richmond Jr. | Physical Therapist | 2578 N Galloway Ave, 100, Mesquite, TX 75150 | 2019-08-23 |
| 1922666916 | Jd Mesquite Dental Pllc | Dentist | 909 Tripp Rd Ste 190, Mesquite, TX 75150 | 2019-06-04 |
| 1134681349 | Champions Rehabilitation, LLC | Clinic/Center | 1675 Republic Parkway Suite 201, Mesquite, TX 75150 | 2019-04-05 |
| 1205317351 | Sheila Katherine Bartley | Occupational Therapist | 3617 O'hare Dr., Mesquite, TX 75150 | 2018-08-27 |
| 1295215028 | Amanda Greene | Occupational Therapy Assistant | 3617 Ohare Drive, Mequite, TX 75150 | 2018-08-21 |
| 1053890244 | Barbara Mohrle | Occupational Therapist | 2231 Us Highway 80e, Willow Bend Nursing and Rehab, Mesquite, TX 75150 | 2018-08-09 |
| 1679052120 | Brenda Johnson | Counselor | 4025 Towne Crossing Blvd Apt 1706, Mesquite, TX 75150 | 2018-08-07 |
| Find all providers in zip 75150 | ||||
| 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 |
|---|---|---|---|---|
| 1609411800 | Mesquite Dental Clinic Pllc | Dentist | 2411 N Galloway Ave Ste 128, Mesquite, TX 75150-7688 | 2019-11-12 |
| 1639661150 | Truecare Dentistry Pllc | Dentist | 1080 E Cartwright Rd Ste 180, Mesquite, TX 75149-6621 | 2018-05-31 |
| 1245751114 | Payden Blake Anderson | Dentist | 340 Falcon Ridge Pkwy Ste 303, Mesquite, NV 89027-8851 | 2017-06-30 |
| 1053769356 | My Teeth Dental Orthodontics Pllc | Dentist | 2063 Town East Mall Ste 1036, Mesquite, TX 75150-4118 | 2016-05-26 |
| 1215397617 | Orange Dental Pllc | Dentist | 2615 Interstate 30, Mesquite, TX 75150-2704 | 2016-02-26 |
| 1821497900 | Dawit Goshimea | Dentist | 1336 N Galloway Ave Ste 110, Mesquite, TX 75149-2490 | 2014-08-14 |
| 1962816355 | Rene Javier Loera Jr. | Dentist | 3133 N Town East Blvd, Mesquite, TX 75150 | 2014-06-13 |
| 1952711681 | Divya Nagaraj | Dentist | 1050 N Belt Line Rd Ste 102, Mesquite, TX 75149-1771 | 2014-05-02 |
| 1164848628 | Jordan Blake Mchone | Dentist | 1765 N Town East Blvd Ste 111, Mesquite, TX 75150 | 2014-03-07 |
| 1346591906 | Tae Gon Song | Dentist | 507 N Galloway Ave, Mesquite, TX 75149-3405 | 2012-09-24 |
| Find all providers in MESQUITE | ||||
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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.