NICOLETTE GENGEL (NPI# 1962939546) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962939546 |
| Entity Type | Individual |
| Full Name | NICOLETTE GENGEL |
| Practice Address |
1384 109th Ave Ne Ste 200 Blaine MN 55434 |
| Mailing Address |
112 Lake Dr S New Fairfield CT 06812-3505 |
| Practice Telephone | 7637576000 |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2018-07-16 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
D14088 | MN | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 112 Lake Dr S, New Fairfield, CT 068123505 | 6093069838 |
| Street Address |
1384 109TH AVE NE STE 200 |
| City | BLAINE |
| State | MN |
| Zip Code | 55434 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413695 | Saad Youssif | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434-4543 | 2020-06-29 |
| 1104302124 | Shalini Mittal | Dentist | 1384 109th Ave Ne Ste 200, Blaine, MN 55434-4543 | 2018-07-12 |
| 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 |
| 1235681958 | Supervalu Pharmacies Inc | Durable Medical Equipment & Medical Supplies | 10881 University Ave Ne, Blaine, MN 55434 | 2016-10-28 |
| Find all providers in zip 55434 | ||||
| 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 |
|---|---|---|---|---|
| 1396398160 | Taylor Johnson | Dentist | 10155 University Ave Ne Ste 112, Blaine, MN 55434-8058 | 2019-07-22 |
| 1982007803 | Blaine Dentistry, PC | Dentist | 1384 109th Ave Ne, Suite 200, Blaine, MN 55434-4515 | 2014-10-06 |
| 1063725109 | Melstrom Dental Pllc | Dentist | 11949 Central Ave Ne, Blaine, MN 55434-3911 | 2010-07-19 |
| 1861703639 | Choong Hyun Lee | Dentist | 341 C Street, Blaine, WA 98230 | 2010-06-28 |
| 1982930525 | John Charles Hitzemann | Dentist | 11354 Wildwood Ct Ne, Blaine, MN 55449-5901 | 2009-11-01 |
| 1477763092 | Donald Lyle Rathe | Dentist | 341 C . St., Blaine, WA 98230 | 2007-05-23 |
| 1154546877 | Carlos Ernesto Campodonico | Dentist | 11806 Aberdeen St Ne Ste 150, Blaine, MN 55449-4748 | 2007-04-16 |
| 1093842841 | Peixin Liu Dds | Dentist | 2407 109th Avenue, Suite 240, Blaine, MN 55449 | 2007-02-28 |
| 1134266869 | John Harold Troselius | Dentist | 9120 Baltimore St Ne, Blaine, MN 55449-4337 | 2007-01-31 |
| 1215003371 | Pdg,p.a. | Dentist | 12904 Central Ave Ne, Blaine, MN 55434-4147 | 2006-11-28 |
| Find all providers in BLAINE | ||||
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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.