OrganizationActive
123 Brush Dental LLC
NPI 1053807016 · Dental Clinic/Center · Maplewood, MN
123 Brush Dental LLC is a Dental Clinic/Center organization in Maplewood, MN (NPI 1053807016).
Provider details
- NPI number
- 1053807016
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Vacharee Peterson, Dentist(651) 779-4195
- License
- D9309 (MN)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1670 Beam Ave
Ste 202
Maplewood, MN 55109
Phone: (651) 779-4195
Street-level locationGet directions
Mailing address
1670 Beam Ave
Maplewood, MN 55109
Registry dates
- Enumerated
- 2018-07-02
- Last updated
- 2018-07-02
Frequently asked questions
- What is 123 Brush Dental LLC's NPI number?
- 123 Brush Dental LLC's National Provider Identifier (NPI) is 1053807016, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is 123 Brush Dental LLC?
- 123 Brush Dental LLC is classified in the NPPES registry as Dental Clinic/Center (Ambulatory Health Care Facilities).
- Where is 123 Brush Dental LLC located?
- 123 Brush Dental LLC's practice location on file with NPPES is 1670 Beam Ave, Maplewood, MN 55109.
- What is 123 Brush Dental LLC's phone number?
- The practice phone number listed in the NPPES registry for 123 Brush Dental LLC is (651) 779-4195.
- Who is the authorized official for 123 Brush Dental LLC?
- The authorized official listed on 123 Brush Dental LLC's NPPES record is Vacharee Peterson, Dentist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is 123 Brush Dental LLC's NPI active?
- Yes — 123 Brush Dental LLC's NPI (1053807016) is active in the NPPES registry as of the last update on 2018-07-02.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.