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NPI Code Detail

MEDICARE: DAKOTA CHILDREN'S DENTISTRY

MEDICARE: DAKOTA CHILDREN'S DENTISTRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223P0221XPediatric DentistryD10462MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811061054
Entity Type Code : Organization
Provider Name (Legal Business Name) : DAKOTA CHILDREN'S DENTISTRY
Provider Business Mailing Address
First Line : 5955 CARMEN AVE
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55076-4416
Country : US
Telephone Number : 651-450-6111
Fax Number : 651-450-0668
Provider Business Practice Location Address
First Line : 5955 CARMEN AVE
Second Line :
City : INVER GROVE HEIGHTS
State : MN
Zip : 55076-4416
Country : US
Telephone Number : 651-450-6111
Fax Number : 651-450-0668
Authorized Official
Title or Position : PRESIDENT
Name : DR. DANIEL H GLENN
Credential : D.D.S, M.S.
Telephone Number : 651-322-5788
Provider Enumeration Date : 11/20/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1154321578 — MRS. LAUREL RUTH ANDERSON M.D.
Practice Location Address:
5975 CARMEN AVE
INVER GROVE HEIGHTS, MN
55076-4416
Practice Phone: 651-455-9697
Practice Fax: 651-455-2012
1982604096 — MRS. MARY THERESA WILD CREA M.D.
Practice Location Address:
5975 CARMEN AVE
INVER GROVE HEIGHTS, MN
55076-4416
Practice Phone: 651-455-9697
Practice Fax: 651-455-2012
1922008044 — MR. ROSS STANLEY OLSON M.D.
Practice Location Address:
5975 CARMEN AVE
INVER GROVE HEIGHTS, MN
55076-4416
Practice Phone: 651-455-9697
Practice Fax: 651-455-2012
1588653729 — DR. DANIEL HAROLD GLENN D.D.S.
Practice Location Address:
5955 CARMEN AVE
INVER GROVE HEIGHTS, MN
55076-4416
Practice Phone: 651-450-6111
Practice Fax: 651-450-0668
1992772107 — RACHEL ELLEN RIDENOUR HERMAN MS RN CNP
Practice Location Address:
5975 CARMEN AVE
INVER GROVE HEIGHTS, MN
55076-4416
Practice Phone: 651-455-9697
Practice Fax: 651-455-2012
1700948536 — JANE E VANROEKEL
Practice Location Address:
5975 CARMEN AVE
INVER GROVE HEIGHTS, MN
55076-4416
Practice Phone: 651-455-9697
Practice Fax:

Directions to “DAKOTA CHILDREN'S DENTISTRY ” Practice Location

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