Alex V Shnaydruk, DDS
Individual provider Active NPI General Practice Dentistry · Rush City, MN
NPI 1306402193 · NPPES record last updated May 16, 2019
Key facts
- NPI
- 1306402193
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D14213 (MN)
- Practice address
- 1220 W 3Rd St
Rush City, MN 55069-9119 - Phone
- (320) 358-4733
- NPI assigned
- May 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D14213 | MN | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ham Lake Dental PLLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D14213 | MN | Yes |
Addresses
Primary practice location
1220 W 3Rd St
Rush City, MN 55069-9119
Mailing address
2393 Molnau CT
Chaska, MN 55318-3221
Phone (952) 261-4307
Other providers in Rush City, MN
- Lisa Marie Reichow
- Rock Elm Country Homes
- Rush City School District
- Stacey Schultz
- Selah Wellness Clinic LLC
- Soft Dental
- St Croix River Education District
- St Croix River Education District
- Teen Focus Recovery Center
- Janelle Marie Traurig
All providers in Rush City, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.