John David Collier, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D11694 Issued in MN

Practice address

3950 Veterans Drive
Suite 102
St. Cloud, MN 56303

Phone

(320) 253-8380

Fax

(320) 253-8419

NPI assigned

Jul 26, 2006

Last updated

Dec 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Koala Dental Care, LLC

  • Pediatric Dentistry
  • Saint Cloud, MN
  • NPI 1730360355
  NPD Authorized official
• K.O.a.L.a. Dental Care, LLC

  • Pediatric Dentistry
  • Saint Cloud, MN
  • NPI 1710317326
  Authorized official Same address or phone

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1558385377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 VETERANS DRIVE",
            "address_2": "SUITE 102",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-253-8380",
            "fax_number": "320-253-8419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 VETERANS DRIVE",
            "address_2": "SUITE 102",
            "city": "ST. CLOUD",
            "state": "MN",
            "postal_code": "56303",
            "telephone_number": "320-253-8380",
            "fax_number": "320-253-8419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLIER",
        "first_name": "JOHN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "11694",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D11694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "11694",
            "state": "MN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "839677900",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D11694",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coborns Inc (Coborn's Pharmacy #2035)
• Coborns Inc (Cash Wise Pharmacy #3041)
• Joseph P. Coffey
• Robin Stacey Colburn, CNM
• Jeremy John Colford, LPN
• John Michael Collier, D.D.S.
• Kelly Sauer Collins, MD
• James David Colt, D.D.S.
• Comfort Care Health LLC
• Communication Plus LLC (Julia Anna Blonigen db Communication Plus)

• Pediatric Dentistry in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Pediatric Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; 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.