TURTLE COVE DENTAL (NPI# 1952867046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952867046 |
| Entity Type | Organization |
| Organization Name | TURTLE COVE DENTAL |
| Practice Address |
14000 Northdale Blvd Ste J Rogers MN 55374-4663 |
| Mailing Address |
Po Box 270511 Saint Paul MN 55127-0511 |
| Practice Telephone | 7634282300 |
| Practice Fax Number | 7634284031 |
| Mailing Telephone | 6513666880 |
| Mailing Fax Number | 6513666881 |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2019-02-14 |
| Authorized Official Name | SAMY BOULOS (OWNER) |
| Authorized Official Telephone | 7634282300 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | BOULOS DENTAL CARE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Turtle Cove Dental | Doing Business As Name - Organization |
| Street Address |
14000 NORTHDALE BLVD STE J |
| City | ROGERS |
| State | MN |
| Zip Code | 55374-4663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194885095 | Lee Steven Prohofsky | Dentist | 14000 Northdale Blvd Ste J, Rogers, MN 55374-4663 | 2006-12-11 |
| 1215097134 | Lee Prohofsky Dds Pa | Dentist | 14000 Northdale Blvd Ste J, Rogers, MN 55374-4663 | 2006-12-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609335835 | Rebecca Loehrer | Nurse Practitioner | 21370 Ste 210 John Milless Dr., Rogers, MN 55374 | 2019-03-18 |
| 1255722328 | Samantha Colai | Marriage & Family Therapist | 21307 John Milless Drive, Suite 106, Rogers, MN 55374 | 2015-02-11 |
| 1437559648 | Jamie Mosley | Counselor | 2100 Rogers Drive, Suite 200, Rogers, MN 55374 | 2014-08-26 |
| 1295145886 | Marisa Kolasa | Massage Therapist | 22290 Oakdale Drive, Rogers, MN 55374 | 2014-05-05 |
| 1871878165 | Derek P Doty Dc Inc | Chiropractor | 21410 136th Ave N, Suite 105a, Rogers, MN 55374 | 2011-10-18 |
| 1912205865 | Michelle Cheryl Finnegan-larson | Registered Nurse | 21308 John Milless Drive, Rogers, MN 55374 | 2011-03-02 |
| 1639402571 | Ascend Family Institute | Community/Behavioral Health | 20980 Rogers Drive, #400, Rogers, MN 55374 | 2009-09-10 |
| 1275738403 | Nicole M Clements | Physician Assistant | 1355 Rogers Drive, Rogers, MN 55374 | 2007-06-18 |
| 1558566166 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 21455 John Milless Drive, Rogers, MN 55374 | 2007-06-15 |
| 1811062854 | Randall Alvin Hohbein | Pharmacist | 21351 John Milless Drive, Rogers Drug, Rogers, MN 55374 | 2006-11-22 |
| Find all providers in zip 55374 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588127021 | Ettienne R Van Zyl, Dds, Pllc | Clinic/Center | 701 S Horsebarn Rd Ste 102, Rogers, AR 72758-8796 | 2019-04-11 |
| 1891273835 | River Dental Rogers | Clinic/Center | 1310 W Walnut St Ste C, Rogers, AR 72756-3300 | 2018-08-01 |
| 1669085155 | Carmen P. Nugent, D.d.d., P.a | Clinic/Center | 1012 W Poplar St, Rogers, AR 72756-4242 | 2020-08-25 |
| 1194336388 | Crystal Bell Norton Dds Pa | Clinic/Center | 5501 W Pinnacle Pointe Dr Ste 1, Rogers, AR 72758-8133 | 2020-08-12 |
| 1699399584 | Karla K Gaines, Dds, Pa | Clinic/Center | 802 N Dixieland Rd, Rogers, AR 72756-3205 | 2020-06-05 |
| 1346743044 | Nathaniel and Katherine Behrents Dds PC | Clinic/Center | 5305 W Village Pkwy Ste 12, Rogers, AR 72758-8116 | 2018-03-09 |
| 1851830889 | Neff Dentistry, Pllc | Clinic/Center | 110 S 20th St, Rogers, AR 72758-1101 | 2017-02-23 |
| 1235538778 | Karla K. Gaines, D.d.s., P.a. | Clinic/Center | 802 N Dixieland Rd, Rogers, AR 72756-3205 | 2014-08-21 |
| 1831342211 | Dentures Today Rogers | Clinic/Center | 4404 W Walnut St, Suite #7, Rogers, AR 72756-9526 | 2008-10-29 |
| 1467600890 | James C. Varner, D.d.s, Pa | Clinic/Center | 3612 Southern Hills Blvd, Rogers, AR 72758-8013 | 2008-08-27 |
| Find all providers in ROGERS | ||||
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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.