Kristine Carol Rosenthal, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11551 Issued in MN

Practice address

15785 95TH Ave N
Maple Grove, MN 55369-4404

Phone

(763) 420-5484

Fax

(763) 420-5875

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kristine Carol Dacosta Former name

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801959242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10015 PLEASURE CREEK CIR NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344233",
            "telephone_number": "763-784-0635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15785 95TH AVE N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553694404",
            "telephone_number": "763-420-5484",
            "fax_number": "763-420-5875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENTHAL",
        "first_name": "KRISTINE",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "DACOSTA",
            "middle_name": "CAROL",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Roots Psychological Services, LLC
• Anne Rosario, P.A.
• Andrew Kern Rosdhal, APRN
• Gary Bernard Rosen, M.D.
• Mary K. Rosenberg, APRN CNP
• Robert Christopher Rothaar, MD
• Noah Andrew Rounds, DDS
• Marilynn Elizabeth Rudolph, RRT, AE-C
• Mary Ruggeri, PA-C
• Jacqueline Marie Ruhland, MSW, LICSW

• General Practice Dentistry in Maple Grove, MN
• Providers in Maple Grove, 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 Jul 8, 2007; 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.