MIDWEST DENTAL - CHISAGO CITY
NPI 1043589484
Dentist - General Practice in Chisago City, MN

Q: What is Modern Dental Professionals Minnesota PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Active since December 14, 2011

29663 GATEWAY AVE, CHISAGO CITY, MN 55013(651) 257-3639 Get Directions Write a Review

NPPES record last updated: December 14, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Midwest Dental - Chisago City NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIDWEST DENTAL - CHISAGO CITY (NPI 1043589484) is a healthcare organization registered as a general practice in Chisago City, Minnesota and active in the NPI registry since December 2011. The organization lists Jeffrey Moos, Ceo, as its authorized official.

NPPES Registry Identity

NPI1043589484

Entity TypeOrganization

Primary Taxonomy1223G0001X

Legal Business NameMODERN DENTAL PROFESSIONALS MINNESOTA PC

Location Address29663 GATEWAY AVEChisago City, MN 55013-0339

Mailing Address29663 Gateway AveChisago City, MN 55013-0339 · (651) 257-3639

Phone(651) 257-3639

Organization SubpartNo

Authorized OfficialJeffrey MoosCeo · (715) 926-5050

Enumeration DateDecember 14, 2011

✔ NPI 1043589484 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Definition

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.

29663 GATEWAY AVE, Chisago City, MN 55013

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Other Names 1

Doing Business AsMidwest Dental - Chisago City

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MARK W JURKOVICH DDS

Dentist (General Practice)

29663 GATEWAY AVE
CHISAGO CITY, MN 55013

Chisago County (651) 257-3639

DR. RILEY SCOTT BAUMGARTNER DDS

Dentist (General Practice)

29663 GATEWAY AVE
CHISAGO CITY, MN 55013

Chisago County (651) 257-3639

DR. REVANA EMAD AWADALLAH DMD

Dentist (General Practice)

29663 GATEWAY AVE
CHISAGO CITY, MN 55013

Chisago County (651) 257-3639

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Modern Dental Professionals Minnesota PC's NPI number?

The NPI number for Modern Dental Professionals Minnesota PC is 1043589484. It was assigned to this organization in the NPPES registry on December 14, 2011. The provider is doing business as Midwest Dental - Chisago City.

Where is Modern Dental Professionals Minnesota PC located?

Modern Dental Professionals Minnesota PC is located at 29663 Gateway Ave, Chisago City, MN 55013. The listed phone number is (651) 257-3639.

What is Modern Dental Professionals Minnesota PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Modern Dental Professionals Minnesota PC accept?

Health plans from UnitedHealthcare list Modern Dental Professionals Minnesota PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Modern Dental Professionals Minnesota PC was last updated on December 14, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.