NPIMap

Organization Active NPI

Group Health Plan, Inc.

Doing business as Three Rivers Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Stillwater, MN
National Provider Identifier
1700975216
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
9652 Issued in MN
Legal business name
GROUP HEALTH PLAN, INC.
Doing business as
Three Rivers Orthodontics
Practice address
1395 Curve Crest Blvd
Stillwater, MN 55082
Phone
(651) 439-1966
Fax
(651) 439-7555
NPI assigned
Oct 12, 2006
Last updated
Dec 29, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
GROUP HEALTH PLAN, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Authorized official

Name
Dr. David S Gesko, DDS
Title
Dental Div/Sr VP
Phone
(952) 883-7577

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 9652MN MN
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 9652 MN Primary

Addresses

Primary practice location

1395 Curve Crest Blvd
Stillwater, MN 55082

Mailing address

1395 Curve Crest Blvd
Stillwater, MN 55082
Phone (651) 439-1966

Other names 1

  • Three Rivers Orthodontics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ramsey Clinic Osceola69 organizations share this tax ID, including this one
Part of
Ramsey Clinic Osceola

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1700975216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CURVE CREST BLVD",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "55082",
            "telephone_number": "651-439-1966",
            "fax_number": "651-439-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CURVE CREST BLVD",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "55082",
            "telephone_number": "651-439-1966",
            "fax_number": "651-439-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUP HEALTH PLAN, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GROUP HEALTH PLAN, INC",
        "enumeration_date": "2006-10-12",
        "last_updated": "2014-12-29",
        "status": "A",
        "authorized_official_last_name": "GESKO",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DENTAL DIV/SR VP",
        "authorized_official_telephone_number": "952-883-7577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "9652MN",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MN",
            "license": "9652",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Orthodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stillwater, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2014; 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.