Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

123 Brush Dental LLC

Organization Dental Clinic/Center · NPI 1053807016

123 Brush Dental LLC is a Dental Clinic/Center in Maplewood, Minnesota. Licensed in Minnesota. Registered with an NPI since 2018.

Licensed in
MN
In the registry since
2018
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1670 Beam Ave Ste 202
Maplewood, MN 55109
Phone: (651) 779-4195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Clinic/Center (primary) Taxonomy 261QD0000X · Licence D9309 (MN)

Record details

NPI number1053807016
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Vacharee Peterson — Dentist · (651) 779-4195
NPI enumeratedJuly 2, 2018
Last updated in NPPESJuly 2, 2018
Mailing address1670 Beam Ave, Ste 202, Maplewood, MN 55109

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