HEALTHY SMILES, INC. NPI 1861720245

Voluntary or Charitable in Claremont, MN

Organization Voluntary or Charitable

About HEALTHY SMILES, INC.

Healthy Smiles, Inc. is a provider established in Claremont, Minnesota specializing in voluntary or charitable. The NPI number of Healthy Smiles, Inc. is 1861720245 and was assigned on November 2009. The practitioner's primary taxonomy code is 251V00000X. The provider is registered as an organization and their NPI record was last updated 11 years ago. The authorized official of this NPI record is Shannon Marie Kruckeberg Rdh (Executive Director)

NPI

1861720245

Provider NameHEALTHY SMILES, INC.
Provider Location Address63407 130TH AVE CLAREMONT, MN 55924
Provider Mailing Address63407 130TH AVE CLAREMONT, MN 55924
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date11-24-2009
Last Update Date11-24-2009

Primary Taxonomy

Taxonomy Code251V00000X
ClassificationVoluntary or Charitable
TypeAgencies

Business Address

HEALTHY SMILES, INC.
63407 130TH AVE
CLAREMONT, MN
ZIP 55924
Phone: (507) 319-6845

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Mailing Address

HEALTHY SMILES, INC.
63407 130TH AVE
CLAREMONT, MN
ZIP 55924
Phone: (507) 319-6845

Authorized Official

Authorized Official Name SHANNON MARIE KRUCKEBERG RDH
Authorized Official TitleEXECUTIVE DIRECTOR
Authorized Official Phone(507) 319-6845

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1003002882 SHANNON MARIE KRUCKEBERG RDH
Individual
Dental Hygienist63407 130TH AVE
CLAREMONT, MN 55924
(507) 319-6845

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.