Distinctive Eyewear, LLC
Distinctive Eyewear, LLC is a healthcare organization registered as Eyewear Supplier in Minnetonka, MN, holding Type 2 (organization) NPI 1104908649 since 2006. The authorized official on file is Kelly Pettengill, Credentialing and Data Management.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1104908649 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Distinctive Eyewear, LLC |
| Other name | <Unavail> |
| Practice address | 6060 CLEARWATER DR STE 150, Minnetonka, MN, 55343 |
| Phone | 7634167656 |
| Fax | 7634167634 |
| Enumeration date | 2006-10-20 |
| Last updated in NPPES | 2020-03-18 |
Authorized official
| Name | Kelly Pettengill |
|---|---|
| Title | Credentialing and Data Management |
| Phone | 7634167629 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 156FX1800X | Optician | Secondary | — | — |
| 332H00000X | Eyewear Supplier | Primary | — | — |
Copy-ready billing details
Provider: Distinctive Eyewear, LLC NPI: 1104908649 Taxonomy: 332H00000X (Eyewear Supplier) Address: 6060 CLEARWATER DR STE 150, Minnetonka, MN, 55343
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1023093390 | William Engel | Individual | Ophthalmology Physician | Minnetonka, MN |
| 1356329189 | Richard Freeman | Individual | Ophthalmology Physician | Minnetonka, MN |
| 1437235280 | Northwest Eye Clinic, LLC | Organization | Ophthalmology Physician | Minnetonka, MN |
Verify this record
Cross-check NPI 1104908649 against the authoritative CMS record: view Distinctive Eyewear, LLC on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What type of organization is Distinctive Eyewear, LLC?
What is a Type 2 NPI?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2020-03-18.