Provider Demographics
NPI:1770478752
Name:CASSUTO, SHIMRIT NAOMI KATE (DDS)
Entity type:Individual
Prefix:DR
First Name:SHIMRIT
Middle Name:NAOMI KATE
Last Name:CASSUTO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SHIMRIT
Other - Middle Name:NAOMI KATE
Other - Last Name:DUVALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4400 MINNETONKA BLVD APT 19
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4077
Mailing Address - Country:US
Mailing Address - Phone:612-296-0472
Mailing Address - Fax:
Practice Address - Street 1:8454 HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-3900
Practice Address - Country:US
Practice Address - Phone:651-461-9619
Practice Address - Fax:952-933-3732
Is Sole Proprietor?:No
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND15273122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist