Mitchell Andrew Loeb, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D13864 Issued in MN

Practice address

140 Twin Rivers CT
Sartell, MN 56377-2015

Phone

(913) 620-2958

NPI assigned

May 31, 2016

Last updated

Apr 12, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mloeb591444@direct.centracare.com

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.

• Mitchell a. Loeb PLLC

  dba Kid Grins

  • Dental Clinic/Center
  • Edina, MN
  • NPI 1588436406
  NPD Authorized official

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

{
    "created_epoch": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618185600000",
    "number": "1881042802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 TWIN RIVERS CT",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772015",
            "telephone_number": "913-620-2958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 TWIN RIVERS CT",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563772015",
            "telephone_number": "913-620-2958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEB",
        "first_name": "MITCHELL",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-31",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2016016887",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl Lindberg, MS, LPCC, LADC
• Gabrielle Christina Lindsay
• Susanne Link
• Michelle Renee Locke
• Elizabeth Grace Locnikar, MS, OTR, ATC
• Leslie G Lofgren, MD
• Lauren Lukasavitz
• Lindsey Lukason
• Christine Marie Lund, PNP
• Jennifer Kay Lund, MSW, LICSW

• Dentist in Sartell, MN
• Providers in Sartell, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.