NORTHWEST EYEWEAR
NPI 1609958230
Eyewear Supplier in Wayzata, MN

Q: What is Distinctive Eyewear LLC's NPI number?

The NPI number for Distinctive Eyewear LLC is 1609958230. It was assigned to this organization in the NPPES registry on October 20, 2006. The provider is doing business as Northwest Eyewear.

Q: What is Distinctive Eyewear LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Active since October 20, 2006

250 CENTRAL AVE N STE 106, WAYZATA, MN 55391(763) 416-7654(763) 416-7634 Get Directions Write a Review

NPPES record last updated: March 18, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Northwest Eyewear NPPES

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

NORTHWEST EYEWEAR (NPI 1609958230) is a healthcare organization registered as an eyewear supplier in Wayzata, Minnesota and active in the NPI registry since October 2006. The organization lists Kelly Pettengill, Credentialing And Data Management, as its authorized official.

NPPES Registry Identity

NPI1609958230

Entity TypeOrganization

Primary Taxonomy332H00000X

Legal Business NameDISTINCTIVE EYEWEAR LLC

Location Address250 CENTRAL AVE N STE 106Wayzata, MN 55391-1207

Mailing Address8401 Golden Valley Rd Ste 330Golden Valley, MN 55427-4488 · (763) 416-7629 · Fax (763) 383-4147

Phone(763) 416-7654

Fax(763) 416-7634

Organization SubpartNo

Authorized OfficialKelly PettengillCredentialing And Data Management · (763) 416-7629

Enumeration DateOctober 20, 2006

Last NPPES UpdateMarch 18, 2020

NPPES CertifiedMarch 18, 2020

✔ NPI 1609958230 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEyewear SupplierSuppliers

Taxonomy Code332H00000X

Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

Also ListedTechnician/Technologist · OpticianTaxonomy 156FX1800X

250 CENTRAL AVE N STE 106, Wayzata, MN 55391

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Other Names 1

Doing Business AsNorthwest Eyewear

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 MULTIPLE SINGLE SPECIALTY GROUP

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 Distinctive Eyewear LLC's NPI number?

The NPI number for Distinctive Eyewear LLC is 1609958230. It was assigned to this organization in the NPPES registry on October 20, 2006. The provider is doing business as Northwest Eyewear.

Where is Distinctive Eyewear LLC located?

Distinctive Eyewear LLC is located at 250 Central Ave N Ste 106, Wayzata, MN 55391. The listed phone number is (763) 416-7654.

What is Distinctive Eyewear LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Distinctive Eyewear LLC was last updated on March 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.