Organization
GROUP HEALTH PLAN INC
Active
Other names
HealthPartners Midway Residency Dental
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BJORKMAN (DIRECTOR)
(952) 883-7469
Entity
Organization
Contact information
Practice address
450 SYNDICATE ST N STE 300, SAINT PAUL, MN 55104-4127
(651) 254-7373
(651) 254-7383
Mailing address
8170 33RD AVE S, MAILSTOP 21113A, BLOOMINGTON, MN 55425-4516
(952) 883-5155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
1223X2210X
Orofacial Pain Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
125J00000X
Dental Therapist
—
—
125K00000X
Advanced Practice Dental Therapist
—
—
Other
Enumeration date
04/05/2022
Last updated
05/28/2025
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