NPIMap

Organization Active NPI

Group Health Plan, Inc

Doing business as Three Rivers Dental Care

  • Dentist
  • Stillwater, MN
National Provider Identifier
1992915649
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10039 Issued in MN
Legal business name
GROUP HEALTH PLAN, INC
Doing business as
Three Rivers Dental Care
Practice address
1395 Curve Crest Blvd W
Stillwater, MN 55082-6069
Phone
(651) 430-0036
Fax
(651) 430-0191
NPI assigned
May 23, 2007
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
Sr. VP/Dental Dir.
Phone
(952) 883-7577

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D10039 MN Primary

Addresses

Primary practice location

1395 Curve Crest Blvd W
Stillwater, MN 55082-6069

Mailing address

1395 Curve Crest Blvd W
Stillwater, MN 55082-6069
Phone (651) 430-0036

Other names 1

  • Three Rivers Dental Care 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 12

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

NPI Registry JSON

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419811200000",
    "number": "1992915649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826069",
            "telephone_number": "651-430-0036",
            "fax_number": "651-430-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826069",
            "telephone_number": "651-430-0036",
            "fax_number": "651-430-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROUP HEALTH PLAN, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GROUP HEALTH PLAN, INC",
        "enumeration_date": "2007-05-23",
        "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": "SR. VP/DENTAL DIR.",
        "authorized_official_telephone_number": "952-883-7577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Three Rivers Dental Care",
            "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.