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

Distinctive Eyewear, LLC

Organization Optician · NPI 1043392632

Distinctive Eyewear, LLC is an Optician in Maple Grove, Minnesota. Registered with an NPI since 2006.

In the registry since
2006
Specialties on file
2
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

12000 Elm Creek Blvd N Ste 100
Maple Grove, MN 55369-7074
Phone: (763) 416-7653
Fax: (763) 416-7634
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Eyewear Supplier (primary) Taxonomy 332H00000X
Optician Taxonomy 156FX1800X

Record details

NPI number1043392632
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kelly Pettengill — Credentialing And Data Management · (763) 416-7629
Other names Northwest Eyewear; Northwest Eyewear
NPI enumeratedOctober 20, 2006
Last updated in NPPESMarch 18, 2020
Certification dateMarch 18, 2020
Mailing address8401 Golden Valley Rd Ste 330, Golden Valley, MN 55427-4488

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