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123 BRUSH DENTAL LLC
NPI 1053807016
Clinic/Center - Dental in Maplewood, MN

Active since July 02, 2018
1670 BEAM AVE, STE 202, MAPLEWOOD, MN 55109(651) 779-4195 Get Directions Write a Review

NPPES record last updated: July 2, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About 123 Brush Dental Llc NPPES

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

123 BRUSH DENTAL LLC (NPI 1053807016) is a healthcare organization registered as a dental in Maplewood, Minnesota and active in the NPI registry since July 2018. The organization lists Vacharee Sriswad Peterson, Dentist, as its authorized official.

NPPES Registry Identity

NPI1053807016
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business Name123 BRUSH DENTAL LLC
Location Address1670 BEAM AVE, STE 202Maplewood, MN 55109
Mailing Address1670 Beam Ave, Ste 202Maplewood, MN 55109 · (651) 779-4195
Phone(651) 779-4195
Organization SubpartNo
Authorized OfficialVacharee Sriswad PetersonDentist · (651) 779-4195
Enumeration DateJuly 2, 2018
✔ NPI 1053807016 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in MN · D9309
1670 BEAM AVE, Maplewood, MN 55109
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Accepted Insurance

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

Other Providers at the Same Location NPPES 20

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

COMMUNITY DENTAL CARE INC
Dentist (General Practice)
1670 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 925-8400
MRS. ALICIA MICHELLE BIBEAU LDH
Dental Hygienist
1670 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 925-8400
COMMUNITY EYE CLINIC
Optometrist
1670 BEAM AVE, STE 202
MAPLEWOOD, MN 55109
Ramsey County (651) 777-6149
AUDREY GREAVES DDS
Dentist
1670 BEAM AVE
SAINT PAUL, MN 55109
Ramsey County (651) 925-8400
MEGAN MEYER M.D.T.
Dental Assistant
1670 BEAM AVE, #204
MAPLEWOOD, MN 55109
Ramsey County (651) 925-8400
DIANE MARIE FISH D.D.S
Dentist (General Practice)
1670 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 925-8400
ERIN TOPLEY DDS
Dentist (General Practice)
1670 BEAM AVE, COMMUNITY DENTAL CARE
MAPLEWOOD, MN 55109
Ramsey County (651) 925-8400
KATHLEEN MARIE GRIMM RDH
Dental Hygienist
1670 BEAM AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 925-8400

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 123 Brush Dental LLC's NPI number?

The NPI number for 123 Brush Dental LLC is 1053807016. It was assigned to this organization in the NPPES registry on July 2, 2018.

Where is 123 Brush Dental LLC located?

123 Brush Dental LLC is located at 1670 Beam Ave Ste 202, Maplewood, MN 55109. The listed phone number is (651) 779-4195.

What is 123 Brush Dental LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

What insurance does 123 Brush Dental LLC accept?

Health plans from UnitedHealthcare list 123 Brush Dental LLC 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 123 Brush Dental LLC was last updated on July 2, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.