Individual provider Active NPI

Maria Mulet Pradera, DDS

  • Dentist
  • Saint Paul, MN
National Provider Identifier
1457452617
Registry record updated Oct 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D12047 Issued in MN
Practice address
2500 Como Avenue - Mail Stop 31100a
Helathpartners Como Clinic
St Paul, MN 55108-1460
Phone
(651) 641-6200
Fax
(651) 641-6205
NPI assigned
Sep 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D12047 MN Primary

Addresses

Primary practice location

2500 Como Avenue - Mail Stop 31100a
Helathpartners Como Clinic
St Paul, MN 55108-1460

Mailing address

8170 33Rd Ave S
Ms21110Q
Minneapolis, MN 55425-4516
Phone (651) 641-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041129000503 MN Practitioner - Oral SurgeryPractitioner - Orofacial Pain 9032174321 Reassigns benefits to 1 organization
Practice locations: Bloomington, MN

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Orofacial Pain
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

2500 Como Ave
Saint Paul, MN 55108-1460
Phone (651) 641-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D12047MNMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. CurrentSince May 19, 2008 Accepting new patients
Group Health, Inc. Dentist CurrentSince May 19, 2008 Accepting new patients
Dakota Valley Oral and Maxillofacial Surgery, PLLC PastSince Sep 1, 2002 Accepting new patients
Minnesota Head and Neck Pain Clinic, PA Past Accepting new patients

Locations

8515 Eagle Point Blvd
Ste 100
Lake Elmo, MN 55042
Phone (651) 259-9501

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

2500 Como Ave
Stop 31100A
Saint Paul, MN 55108
Phone (651) 641-6200

3930 Northwoods Dr
Saint Paul, MN 55112
Phone (651) 490-6775

2500 Como Ave
Saint Paul, MN 55108
Phone (651) 641-6200

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1457452617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516",
            "telephone_number": "651-641-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 COMO AVENUE - MAIL STOP 31100A",
            "address_2": "HELATHPARTNERS COMO CLINIC",
            "city": "ST PAUL",
            "state": "MN",
            "postal_code": "551081460",
            "telephone_number": "651-641-6200",
            "fax_number": "651-641-6205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULET PRADERA",
        "first_name": "MARIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.