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Distinctive Eyewear, LLC

Eyewear Supplier in Golden Valley, MN · enumerated 2006 · authorized official Kelly Pettengill, Credentialing and Data Management.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1154403723

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Registry record

Entity type Organization (Type 2)
Legal business name Distinctive Eyewear, LLC
Other name <Unavail>
Practice address 8501 Golden Valley Rd Ste 100, Golden Valley, MN, 55427
Phone (763) 416-7655
Fax (763) 416-7634
Enumeration date Oct 20, 2006
Last updated in NPPES Mar 19, 2020

Taxonomy & classification

156FX1800X Optician Eye and Vision Services Providers Secondary
332H00000X Eyewear Supplier Suppliers Primary

Authorized official

Name Kelly Pettengill
Title Credentialing and Data Management
Phone (763) 416-7629

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.

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Frequently asked questions

Who is the authorized official for Distinctive Eyewear, LLC?
NPPES lists Kelly Pettengill (Credentialing and Data Management) as the authorized official for this organization.
What is the NPI number for Distinctive Eyewear, LLC?
The NPI for Distinctive Eyewear, LLC is 1154403723, a Type 2 (organization) record in the CMS NPPES registry.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2020-03-19.