Malina Teodoru

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12674 Issued in MN

Practice address

13550 26TH Ave N
Plymouth, MN 55441-3650

Phone

(763) 557-0287

Fax

(763) 557-0295

NPI assigned

Jun 26, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424131200000",
    "number": "1750519930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14376 ASPEN AVE NE",
            "city": "PRIOR LAKE",
            "state": "MN",
            "postal_code": "553721307",
            "telephone_number": "952-992-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13550 26TH AVE N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554413650",
            "telephone_number": "763-557-0287",
            "fax_number": "763-557-0295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEODORU",
        "first_name": "MALINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2015-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D12674",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN BOARD OF DENTISTRY",
            "identifier": "D12674",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shanice L Taylor
• TC Healthcare
• Kathryn Rose Teague, D.O.
• Julia Teich, DPT
• Tendercare Home Services Inc.
• The Eye Surgery Center of Plymouth, LLC
• The Good Samaritan Staffing
• The Papillon Effect Wellness PLLC
• Rachel Marie Theisen
• Ryan O Theisen, LADC, LPCC

• General Practice Dentistry in Plymouth, MN
• Providers in Plymouth, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.