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General NPI Number Information
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NPI Number | 1073461810
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Entity Type | Organization
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Legal Business Name | TWIN CITIES CHILDREN'S ANESTHESIA DENTISTRY, PLLC
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Dates
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Enumeration Date | 03/18/2026
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Last Update Date | 03/18/2026
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Provider Practice Location Address
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Address Line | 1997 SLOAN PL STE 30
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City | MAPLEWOOD
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State | MN
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Zip | 55117-2051
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Country | US
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Telephone | 651-383-3333
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Fax | 651-383-8888
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Provider Business Mailing Address
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Address Line | 1997 SLOAN PL STE 30
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City | MAPLEWOOD
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State | MN
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Zip | 55117-2051
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Country | US
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Telephone | 651-383-3333
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Fax | 651-383-8888
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Authorized Official
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Title or Position | CEO
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Name | JEFFREY WHEELER
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Credential |
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Telephone | 301-494-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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