Tla DDS PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

TLA DDS PLLC

Doing business as

Renu Dental

Practice address

2211 Sahlstrom Dr Ste a
Crookston, MN 56716-2827

Phone

(218) 281-1301

NPI assigned

Apr 29, 2022

Last updated

May 20, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tiara Applequist, DDS

Title

Owner

Phone

(218) 281-1301

Specialties & licenses 1

Addresses

Other names 1

• Renu Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Megan Marie Bahnmiller, DDS

  • Dentist
  • Crookston, MN
  • NPI 1669215109
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1073258471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 SAHLSTROM DR STE A",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162827",
            "telephone_number": "218-281-1301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 SAHLSTROM DR STE A",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567162827",
            "telephone_number": "218-281-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLA DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "APPLEQUIST",
        "authorized_official_first_name": "TIARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "218-281-1301",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renu Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mary Alice Thibert, LADC
• Brianne Christine Thompson, LPCC
• Nancy D Thompson, PMHNP
• Valerie Sue Thompson
• Thrifty Drug Stores Inc (Thrifty White Drug #729)
• Tri-County Community Corrections
• Tri-Valley Opportunity Council
• Nancy Ann Trickey, LICSW
• Jennifer Christine Tull, MPT
• Nancy Tuseth

• Dental Clinic/Center in Crookston, MN
• Providers in Crookston, MN by specialty
• Dental Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.