NORTHLAND ENDODONTICS PA (NPI# 1932200037) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932200037 |
| Entity Type | Organization |
| Organization Name | NORTHLAND ENDODONTICS PA |
| Practice Address |
11800 Aberdeen St Ne Suite 140 Blaine MN 55449-4808 |
| Practice Telephone | 7637720330 |
| Practice Fax Number | 7637720354 |
| Mailing Telephone | 7637720330 |
| Mailing Fax Number | 7637720354 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. KRIS DAVID JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 7637720330 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
D10585 | MN | Dental Providers |
| Street Address |
11800 ABERDEEN ST NE SUITE 140 |
| City | BLAINE |
| State | MN |
| Zip Code | 55449-4808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962821181 | Amanda Neumann | Marriage & Family Therapist | 11800 Aberdeen St Ne, Ste 100, Blaine, MN 55449 | 2014-04-15 |
| 1396004586 | Michael J Boike | Marriage & Family Therapist | 11800 Aberdeen St Ne, Ste 100, Blaine, MN 55449-4810 | 2012-05-09 |
| 1730355603 | Therapy Connections, LLC | Community/Behavioral Health | 11800 Aberdeen St Ne, Suite 100, Blaine, MN 55449-4810 | 2008-05-01 |
| 1538220207 | Aberdeen Dental Associates | Dentist | 11800 Aberdeen St Ne, Suite 110, Blaine, MN 55449-4808 | 2006-12-13 |
| 1386702561 | Jill Diane Boike | Social Worker | 11800 Aberdeen St Ne, Suite 100, Blaine, MN 55449-4810 | 2006-12-04 |
| 1144393745 | Michael Joseph Hauwiller | Dentist | 11800 Aberdeen St Ne, Suite 110, Blaine, MN 55449-4808 | 2006-11-15 |
| 1932298460 | Donna Jean Mattscheck | Dentist | 11800 Aberdeen St Ne, #140, Blaine, MN 55449-4808 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033736368 | Landon Thomas Case | Dentist | 10729 Town Square Drive Ne, Ste 100, Blaine, MN 55449 | 2020-07-02 |
| 1881168441 | Ear Institutes, LLC | Otolaryngology | 4365 Pleasant Ridge Dr Ne, Suite 106, Blaine, MN 55449 | 2019-01-17 |
| 1841776242 | Kristin Broback | Nurse Practitioner | 10705 Town Square Dr Ne #100, Blaine, MN 55449 | 2018-07-18 |
| 1043719016 | Robin Lynn Broen | Registered Nurse | 3012 129th Ave Ne, Blaine, MN 55449 | 2018-02-06 |
| 1194197368 | Lund Health Professional Corporation | Chiropractor | 1360 101st Ave Ne, Suite 140, Blaine, MN 55449 | 2015-10-27 |
| 1871989806 | Blaine Wp II, LLC | Assisted Living Facility | 12402 Jamestown Street Ne, Blaine, MN 55449 | 2015-04-07 |
| 1154761633 | Jean Budge | Marriage & Family Therapist | 11800 Aberdeen Street Ne, Suite 100, Blaine, MN 55449 | 2013-06-28 |
| 1295013498 | Jeff K Yu | Veterinarian | 11850 Aberdeen St Ne, Blaine, MN 55449 | 2011-07-22 |
| 1528394707 | Julie Ann Eibensteiner | Physical Therapist | 11304 Davenport Circle Ne #a, Minneapolis, MN 55449 | 2009-10-23 |
| 1871725333 | Deborah Kathryn Zongo | Nurse Practitioner | 10190 Baltimore St Ne Ste 100, Blaine, MN 55449 | 2009-08-18 |
| Find all providers in zip 55449 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922308113 | Dental Specialists of Minnesota, Pllc | Dentist | 12904 Central Ave. Ne, Blaine, MN 55434 | 2010-10-22 |
| 1881894137 | Kris David Johnson | Dentist | 11800 Aberdeen St. Ne, Suite 140, Blaine, MN 55449 | 2007-07-24 |
| 1629199617 | St. Croix Endodontics, P.a. | Dentist | 11945 Central Ave Ne, Blaine, MN 55434-3911 | 2007-04-03 |
| 1932298460 | Donna Jean Mattscheck | Dentist | 11800 Aberdeen St Ne, #140, Blaine, MN 55449-4808 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568071199 | Dental Specialist of Minnesota, Pllc | Dentist | 18258 Minnetonka Blvd Ste 100, Wayzata, MN 55391-3324 | 2020-07-29 |
| 1215588660 | The Dental Specialist of Minnesota, Pllc | Dentist | 324 W Superior St Ste 824, Duluth, MN 55802-1718 | 2019-09-26 |
| 1780236539 | Modern Care Endodontics of Apple Valley | Dentist | 15160 Foliage Ave Ste 100, Apple Valley, MN 55124-5916 | 2019-07-11 |
| 1699268052 | Christopher Rex Lai | Dentist | 8-166 Moos Health Sciene Tower, 515 Delaware St. Se, Minneapolis, MN 55455 | 2018-06-11 |
| 1699272427 | Group Health Plan Inc | Dentist | 5500 Excelsior Blvd, St Louis Park, MN 55416-2935 | 2018-04-09 |
| 1225533037 | Younghyup Byun | Dentist | 1900 Kruchten Ct S Ste 100, Sartell, MN 56377-4731 | 2018-03-26 |
| 1275034886 | Great River Endodontics | Dentist | 9381 Cedar St., Monticello, MN 55362 | 2018-02-28 |
| 1417464157 | Deer River Dental Clinic | Dentist | 111 Main Street E, Deer River, MN 56636 | 2018-01-03 |
| 1174045975 | The Dental Specialists of Minnesota, Pllc | Dentist | 4640 Nicols Rd Ste 202, Eagan, MN 55122-7400 | 2017-07-13 |
| 1861914061 | The Dental Specialist of Minnesota, Pllc | Dentist | 2550 University Ave W Ste 155s, Saint Paul, MN 55114-1098 | 2017-07-10 |
| 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.