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

Justin Nwosu

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1104673227

Justin Nwosu is a Student in an Organized Health Care Education/Training Program in Bloomington, Minnesota. Licensed in Minnesota. Registered with an NPI since 2024.

Licensed in
MN
In the registry since
2024
Specialties on file
2

Practice location Address checks out

7936 Portland Ave S
Bloomington, MN 55420-1315
Phone: (952) 852-7776
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence D15172 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1104673227
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMay 6, 2024
Last updated in NPPESJuly 17, 2024
Certification dateJuly 17, 2024
Mailing address2000 Pin Oak Pkwy, Bowie, MD 20721-3098

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