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NPI Code Detail

MEDICARE: GROUP HEALTH PLAN INC

MEDICARE: GROUP HEALTH PLAN INC
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
1125J00000XDental Therapist
21223X2210XOrofacial Pain Dentistry
3122300000XDentist
41223E0200XEndodontics
5124Q00000XDental Hygienist
61223P0300XPeriodontics
7125K00000XAdvanced Practice Dental Therapist
81223P0221XPediatric Dentistry
91223S0112XOral and Maxillofacial Surgery (Dentist)
101223P0106XOral and Maxillofacial Pathology Dentistry
111223P0700XProsthodontics
121223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1952042053
Entity Type Code : Organization
Provider Name (Legal Business Name) : GROUP HEALTH PLAN INC
Provider Business Mailing Address
First Line : 8170 33RD AVE S
Second Line : MAILSTOP 21113A
City : BLOOMINGTON
State : MN
Zip : 55425-4516
Country : US
Telephone Number : 952-883-5155
Fax Number :
Provider Business Practice Location Address
First Line : 205 WABASHA ST S
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-1805
Country : US
Telephone Number : 651-254-7373
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : LISA BJORKMAN
Credential :
Telephone Number : 952-883-7469
Provider Enumeration Date : 04/05/2022
Last Update Date : 06/09/2026

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