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Distinctive Eyewear, Llc

Eyewear Supplier

KELLY PETTENGILL
NPI: 1043392632Maple Grove, Minnesota, 55369(763) 416-7653

About Distinctive Eyewear, Llc

Distinctive Eyewear, Llc is a healthcare organization providing Eyewear Supplier services, registered under National Provider Identifier (NPI) number 1043392632. The authorized official for Distinctive Eyewear, Llc is KELLY PETTENGILL.

The organization is headquartered at 12000 ELM CREEK BLVD N STE 100, Maple Grove, Minnesota 55369. The main office can be reached at (763) 416-7653. Distinctive Eyewear, Llc has been NPI-registered since 2006.

Locations & Contact

Primary Location

Address
12000 ELM CREEK BLVD N STE 100
City
Maple Grove
State
Minnesota
ZIP
55369-7074
Phone
(763) 416-7653
Fax
(763) 416-7634
View on Google Maps

Authorized Official

Name
KELLY PETTENGILL

Mailing Address

Address
8401 GOLDEN VALLEY RD STE 330
City
GOLDEN VALLEY
State
MN
ZIP
554274488

NPI Registration

Enumeration Date
Last Updated
Certification Date

Services & Taxonomy

Specialty & Classification

Primary Specialty
Eyewear Supplier
Classification
Eyewear Supplier
Taxonomy Code
332H00000X

Medicare Enrollment

Medicare Enrolled
No
Can Order/Refer
No
Telehealth
No
Excluded
No

Frequently Asked Questions

What is Distinctive Eyewear, Llc's NPI number?
Distinctive Eyewear, Llc's National Provider Identifier (NPI) is 1043392632. An NPI is a unique 10-digit identification number issued by the Centers for Medicare & Medicaid Services (CMS) to healthcare providers in the United States.
What does Distinctive Eyewear, Llc specialize in?
Distinctive Eyewear, Llc specializes in Eyewear Supplier.
Where is Distinctive Eyewear, Llc located?
Distinctive Eyewear, Llc practices at 12000 ELM CREEK BLVD N STE 100, Maple Grove, Minnesota 55369. You can reach them by phone at (763) 416-7653.
Does Distinctive Eyewear, Llc accept Medicare?
Based on available data, Distinctive Eyewear, Llc is not currently enrolled in the Medicare program.
Does Distinctive Eyewear, Llc offer telehealth or virtual visits?
Distinctive Eyewear, Llc does not currently offer telehealth services. In-person visits are required at their practice location.

What is a Type 2 NPI (Organization)?

A Type 2 NPI is assigned to healthcare organizations such as hospitals, group practices, clinics, and other medical entities. Unlike Type 1 NPIs issued to individual providers, a Type 2 NPI identifies the organization itself and is used for billing, claims processing, and identification in healthcare transactions. Distinctive Eyewear, Llc holds NPI 1043392632, which serves as its unique identifier across all Medicare and HIPAA-covered transactions.